Abstract 1478
Background
Concurrent chemoradiation (CRT) improves survival in squamous cell carcinoma of the head and neck (HNSCC). Little is known about the outcomes of elderly patients (pts, ≥70 years old) in terms of treatment efficacy and side effects. This retrospective study compares acute toxicity, response to therapy, and overall survival between elderly pts receiving different CRT combinations.
Methods
Pts. without dementia, deficit on instrumental activities of daily living, Charlson comorbidity index <2, and living at home with a family member received CRT. Pts received one of the following: 1) weekly carboplatin AUC 1 and paclitaxel 30mg/m2 for seven doses (CP), 2) cetuximab loading dose of 400 mg/m² followed by 250 mg/m² weekly for seven doses (CE), 3) weekly carboplatin AUC 1.5 for seven doses (CB), 4) weekly cisplatin 40 mg/m2 for seven doses (CIS). Radiation was administered to a dose of 70 Gy as definitive treatment or 66 Gy as adjuvant treatment (2 Gy/fraction).
Results
150 pts. (M/F: 111/39) with mean age 74.6 (range 70-88) were identified. 52 pts (34.7%) received adjuvant and 98 (65.3%) definitive CRT. Tumor site: oropharynx 74 (49.5%), oral cavity (17.5%), larynx 14%, others (19%). 60 pts (40%) were p-16 positive. 44 patients (29.5%) received CP, 43 (28.5%) CE 33 (22%) CB, and 30 (20%) CIS. 110 pts (73.5%) had a complete response (CR). 90 pts (60%) were admitted to the hospital during CRT, and pneumonia was the most common diagnosis (59 pts, 39.5%). 98 pts (65.5%) had percutaneous endoscopic gastrostomy tube (PEG) due to G3 mucositis. Two patients (1.3%) experienced G5 cardiovascular toxicity. At 6 months, 38 (25.3%) still had PEG, and was associated with CRT regimen (p = 0.001): 6/44(14%) received CP, 22/43 (51%) CE, 4/33 (12%) CB, and 6/30 (20%) CIS. The overall survival at 3 yrs was 60% (95% confidence interval (CI), 52%-71%). The predictors for OS at 3 yrs were response to therapy (CR 78% (68%-88%), and non-CR 17% (7%-37%); P < 0.0001), and CRT regimen (CB 41% (25%- 66%) vs others 66%, (57%- 78%); P = 0.01).
Conclusions
CRT can be administered to a selected elderly population with HNSCC. Single agent CB was associated with worse outcomes. CE seems to be related to a higher rate of long term PEG dependence.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The Ohio State University, James Cancer Hospital and Solove Research Institute.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4489 - A Window of Opportunity Trial of Atorvastatin Targeting p53 Mutant Malignancies
Presenter: Joaquina Baranda
Session: Poster Display session 3
Resources:
Abstract
1945 - Randomized Phase II Study of Trabectedin/Olaparib Compared to Physician’s Choice in Subjects with Previously Treated Advanced or Recurrent Solid Tumors Harboring DNA Repair Deficiencies.
Presenter: Christoph Heilig
Session: Poster Display session 3
Resources:
Abstract
3021 - Homogenisation of Leftover Surgical Tissue across multiple cancer types: a Feasibility Study (HoLST-F)
Presenter: Lavinia Spain
Session: Poster Display session 3
Resources:
Abstract
2882 - Safety, efficacy, and immune effects of intratumoral tilsotolimod in patients with refractory solid tumors: updated results from ILLUMINATE-101
Presenter: Hani Babiker
Session: Poster Display session 3
Resources:
Abstract
1950 - Phase 1 Dose Escalation of MSC-1, a humanized anti-LIF monoclonal antibody, in patients (pts) with advanced solid tumors: Updated results
Presenter: Erkut Borazanci
Session: Poster Display session 3
Resources:
Abstract
2391 - A phase 1 study of Sym021, an anti-PD-1 antibody (Ab), alone and in combination with Sym022 (anti-LAG-3) or Sym023 (anti-TIM-3)
Presenter: Anna Spreafico
Session: Poster Display session 3
Resources:
Abstract
5692 - FPA150 (B7-H4 antibody) Phase 1 Update in Advanced Solid Tumors: Monotherapy and in Combination with Pembrolizumab
Presenter: Zev Wainberg
Session: Poster Display session 3
Resources:
Abstract
2416 - MG1124, a novel CEACAM1-targeted monoclonal antibody, has therapeutic potential as a combination partner of PD-1 inhibitors in NSCLC patients
Presenter: Eun Hee Lee
Session: Poster Display session 3
Resources:
Abstract
2661 - Tumor stroma targeting and modulation by OMTX705 ADC, a novel and potent immunotherapeutic treatment of solid tumors.
Presenter: Myriam Fabre
Session: Poster Display session 3
Resources:
Abstract
3681 - Durvalumab + monalizumab, mFOLFOX6, and bevacizumab in patients (pts) with metastatic microsatellite-stable colorectal cancer (MSS-CRC)
Presenter: May Cho
Session: Poster Display session 3
Resources:
Abstract