277P - Tegafur/uracil, platinum and cetuximab (UPEx) as first line treatment in frail patients with recurrent or metastatic head and neck squamous cell carcinoma

Background

Cetuximab in combination with platinum and 5-fluorouracil is the standard of care in the first-line treatment of patients with recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). However, this seems too toxic for patients with frailty. Our study evaluated the efficacy and safety of tegafur/uracil (UFUR) associated with platinum and cetuximab (UPEx) in frail patients with R/M HNSCC.

Methods

Our study recruited frail patients who were aged > 70 years or performance status (PS) >2. Patients with a histologically confirmed R/M HNSCC unsuitable for locoregional curative therapy were treated with UPEx. The doses of UPEx were Tegafur 200mg twice per day for 14 days, cisplatin 30mg/m(2) at day 1 and cetuximab 500mg/m(2) at day 1, repeated every 2 weeks until progression or unacceptable toxicity. For patients with unfit renal function, carboplatin AUC =2 was used instead of cisplatin. The objective response rate (ORR), overall survival (OS) and progression-free survival (PFS) was estimated.

Results

Forty-two patients were enrolled, including 81% aged > 70 years and 19% PS >2. The primary tumor mainly located in hypopharynx (43%) and oral cavity (43%), followed by oropharynx (10%) and larynx (4%). The ORR was 67%. Median OS and PFS were, respectively, 9.7 months (95% CI 7.4-11.9) and 5.8 months (95% CI 5.1-6.5). No patients had grade 3/4 adverse effects leading to discontinue treatment in our study.

Conclusions

The UPEx regimen was effective and tolerable as first-line treatment in frail patients with R/M HNSCC.

Clinical trial identification

Editorial acknowledgement

The authors thank the heda and neck cancer working group at E-Da hospital for their great assistance of data reviewing and examining.

Legal entity responsible for the study

Meng-che Hsieh.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.