Abstract 897P
Background
TPF (Docetaxel, Platinum & 5-Fluorouracil) or TP regimen as neoadjuvant chemotherapy (NACT) in head and neck cancer are associated with a high rate of adverse events. Many of these adverse events are contributed by docetaxel. We wanted to analyze whether a change in formulation from conventional docetaxel to nanosomal docetaxel lipid suspension (NDLS, Doceaqualip) leads to decreased adverse events.
Methods
This was an exploratory analysis from the data of a prospective, single-center, phase 3 randomized study. The patients received either the TPF or TP regimen as a part of randomized study. The choice of docetaxel was at physician discretion. The adverse events rate during NACT were captured as per NCI- Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 Out of 495 patients, data for adverse events and formulations was captured in 479 patients. Among these, we had 4 groups- Group-1 : NDLS in all cycles (192 (40.1%)), Group 2: docetaxel in all cycles ( 172(35.9%)), Group 3 : 1st cycle NDLS and rest docetaxel (64 (13.4%)) and Group 4: 1st cycle docetaxel and rest NDLS (51 (10.6%)). For this analysis we have restricted the comparison between group 1 & 2. A univariate analysis with Fisher's test was performed to study whether the different formulations had any impact on adverse event rate. The response rate and overall survival (OS) were compared between the 2 formulations.
Results
The use of NDLS led to a significant decrease in the incidence of mucositis and neutropenia (Table). The efficacy was statistically similar between group 1 and 2 with respect to response rates (24.7% versus 29.6%, P=0.301), and median OS (10.1 [8.526-11.674] versus 11.37 [10.320-12.414], P=0.07). Any Grade
Table: 897P
Parameter, n (%) | Group 1 (n=192) NDLS | Group 2 (n=172) Docetaxel | P-value |
Mucositis | 84 (43.8) | 113 (65.7) | 0.000 |
Weight loss | 27 (14.1) | 31 (18) | 0.373 |
Nausea | 65 (33.9) | 59 (34.3) | 0.132 |
Vomiting | 50 (26) | 52 (30.2) | 0.830 |
Diarrhea | 100 (52.1) | 109 (63.4) | 0.174 |
Neutropenia | 79 (41.1) | 97 (56.4) | 0.012 |
Anemia | 154 (80.2) | 143 (83.1) | 0.189 |
Thrombocytopenia | 50 (26) | 66 (38.4) | 0.092 |
Rise in creatinine | 17 (8.9) | 6 (3.5) | 0.088 |
Hyponatremia | 161 (83.9) | 147 (85.5) | 0.290 |
Hypokalemia | 75 (39.1) | 103 (59.9) | 0.001 |
Hypomagnesemia | 103 (53.6) | 110 (64.0) | 0.022 |
SGOT rise | 48 (25.0) | 37 (21.5) | 0.620 |
SGPT rise | 72 (37.5) | 48 (27.9) | 0.080 |
Conclusions
Use of NDLS formulation instead of conventional docetaxel leads to a decrease in adverse events like mucositis and neutropenia when used as neoadjuvant therapy in oral squamous cell carcinoma with similar efficacy.
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.
Resources from the same session
868P - A DNA methylation classifier to predict recurrence from clear surgical margins
Presenter: tsima Abou Kors
Session: Poster session 12
869P - Utilizing H&E images and digital pathology to predict response to buparlisib in SCCHN
Presenter: Denis Soulieres
Session: Poster session 12
870P - Dynamic cfHPV DNA changes during induction chemotherapy as an early indicator of treatment responsiveness for locally advanced head and neck cancer patients
Presenter: Yilin Cao
Session: Poster session 12
871P - Detection of circulating tumor DNA in operable loco-regionally advanced HPV-negative head and neck squamous cell carcinoma
Presenter: Ludivine Beaussire
Session: Poster session 12
872P - Prognostic value of pathological intratumor heterogeneity in patients with head and neck squamous cell carcinoma treated with upfront surgery
Presenter: Constance Lamy
Session: Poster session 12
873P - Identification of PIK3CA mutation as a novel predictor of efficacious immunotherapy in head and neck cancer
Presenter: Zongwen Sun
Session: Poster session 12
875P - Proteomic and phosphoproteomic profiling of HNSCC and the role of CDKs as potential drug targets
Presenter: Konrad Klinghammer
Session: Poster session 12
876P - Gene expression analysis in oral potentially malignant disorders (OPMD) with dysplasia identifies patients at high risk of malignant transformation
Presenter: Loris De Cecco
Session: Poster session 12
877P - ROS1 mutations as potential negative predictor for response of immunotherapy in patient with head and neck cancer
Presenter: Yong Yuan
Session: Poster session 12