Abstract 915P
Background
HNC are the sixth most common malignancy diagnosed worldwide and is the most common cancer of males in India and treatment in recurrent/metastatic setting is challenging. For patients with R/M HNSSC, the EXTREME regimen has been established as standard of care in the first-line treatment for more than 10 years. However, many patients are not eligible for this regimen due to various reasons also including patients’ choice and logistics. This retrospective study aimed to evaluate the efficacy and tolerability of carboplatin and paclitaxel as first line treatment in patients with R/M HNC.
Methods
We retrospectively reviewed the data of histologically confirmed R/M HNSCC with the ECOG PS of 0-2 and at least unidimensional measurable lesion by imaging who received carboplatin and paclitaxel combination three weekly as first line therapy at KMIO, Bangalore, between Jan 2018 and Dec 2019. Nasopharyngeal primary tumors did not form a part of this analysis. A total of six cycles was administered. Patients were followed up every two months at the end of treatment till the last date of follow up. Patients' profile, response rate, toxicities of the regimen, progression free survival (PFS) and overall survival (OS) were evaluated.
Results
In total 182 patients received carboplatin and paclitaxel combination three weekly as first line therapy, and of them 74.7% were male. The median age was 49 years (Range; 32-78). Most of the patients (58.7%) had an ECOG PS 1. The oral cavity was the most common site (37.9%), followed by the oropharynx (28.8%). At the end of treatment, overall response rate and disease control rate was 40.6% and 15.3%, respectively. Median PFS was 4.3 months (95%CI; 2.9–5.6) and the median OS was 8.2 months (95% CI;6.8-9.7). This was a tolerable regimen with 19.7% grade ¾ hematological toxicity and 4.3% non-hematological grade ¾ toxicity. None of the patients died due to treatment related complications.
Conclusions
Carboplatin with three weekly paclitaxel is preferred for most patients unfit to cisplatin and to EXTREME regimen. This is a feasible regimen in terms of outcomes, tolerability and patient logistics including cost in resource limiting settings in R/M HNC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.