An Exploratory Study of Neoadjuvant Cetuximab Followed by Cetuximab and Chemoradiotherapy in Women With Newly Diagnosed Locally Advanced Cervical Cancer.

Autor:	Fracasso PM; UVA Cancer Center.; Departments of Medicine., Duska LR; UVA Cancer Center.; Obstetrics and Gynecology., Thaker PH; Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine.; Departments of Obstetrics and Gynecology., Gao F; Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine.; Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine., Zoberi I; Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine.; Radiation Oncology., Dehdashti F; Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine.; Division of Nuclear Medicine., Siegel BA; Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine.; Division of Nuclear Medicine., Uliel L; Division of Nuclear Medicine., Menias CO; Division of Diagnostic Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO., Rehm PK; Division of Nuclear Medicine, University of Virginia, Charlottesville, VA., Goodner SA; UVA Cancer Center., Creekmore AN; Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine., Lothamer HL; Obstetrics and Gynecology., Rader JS; Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine.; Departments of Obstetrics and Gynecology.
Jazyk:	angličtina
Zdroj:	American journal of clinical oncology [Am J Clin Oncol] 2022 Jul 01; Vol. 45 (7), pp. 286-293. Date of Electronic Publication: 2022 Jun 07.
DOI:	10.1097/COC.0000000000000926
Abstrakt:	Objectives: This study explored the feasibility of cetuximab with chemoradiation in women with cervical carcinoma and evaluated fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) to assess early response to cetuximab (NCT00292955). Patients and Methods: Eligible patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB-IVB invasive carcinoma of the uterine cervix were treated on 1 of 3 dose levels (DL). DL1 consisted of neoadjuvant cetuximab, then concurrent radiotherapy with cetuximab 250 mg/m2/cisplatin 40 mg/m2, followed by weekly cetuximab. DL2 consisted of radiotherapy with cetuximab 200 mg/m2 and cisplatin 30 mg/m2. DL3 consisted of radiotherapy with cetuximab 250 mg/m2 and cisplatin 30 mg/m2. Patients underwent 18F-FDG-PET/CT before treatment, after neoadjuvant cetuximab, and at the end of treatment. Results: Of the 21 patients enrolled, 9, 3, and 9 were treated in DL1, DL2, and DL3, respectively. DL1 required dose reductions due to gastrointestinal toxicities. DL2 and 3 were tolerated with 1 dose-limiting toxicity (grade 4 renal failure) at DL3. Following 3 weekly treatments of neoadjuvant cetuximab in DL1, 7 patients had maximum standardized uptake value changes on 18F-FDG-PET/CT consistent with response to cetuximab. Of the 12 patients with locally advanced disease, eleven evaluable patients had no evidence of disease on 18F-FDG-PET/CT at treatment end. Five-year progression-free survival and overall survival rates for all patients were 57.5% and 58.5%, respectively. Conclusions: Cetuximab with cisplatin 30 mg/m2 and radiotherapy was tolerated. 18F-FDG-PET/CT demonstrated early evidence of response to neoadjuvant cetuximab. With advances in precision oncology and the recent approval of pembrolizumab in metastatic cervical cancer, dual-target inhibition with an epidermal growth factor receptor inhibitor may be a promising treatment in the future. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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