Activity of weekly paclitaxel-cetuximab chemotherapy in unselected patients with recurrent/metastatic head and neck squamous cell carcinoma: prognostic factors

Autor: L. Calera Urquizu, J. Martinez Trufero, R.A. Pazo Cid, I. Pajares Bernad, Antonio Antón, A. Cebollero de Miguel, M. J. Agustin, M. Lanzuela
Rok vydání: 2016
Předmět:
0301 basic medicine
Oncology
Adult
Male
Cancer Research
medicine.medical_specialty
Combination therapy
Paclitaxel
medicine.medical_treatment
Phases of clinical research
Cetuximab
Kaplan-Meier Estimate
Disease-Free Survival
03 medical and health sciences
0302 clinical medicine
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
Medicine
Humans
Progression-free survival
Aged
Proportional Hazards Models
Retrospective Studies
Aged
80 and over
Chemotherapy
business.industry
Squamous Cell Carcinoma of Head and Neck
Standard treatment
General Medicine
Middle Aged
medicine.disease
Prognosis
Comorbidity
Head and neck squamous-cell carcinoma
030104 developmental biology
Treatment Outcome
Head and Neck Neoplasms
030220 oncology & carcinogenesis
Carcinoma
Squamous Cell
Female
Neoplasm Recurrence
Local
business
medicine.drug
Zdroj: Clinicaltranslational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico. 19(6)
ISSN: 1699-3055
Popis: Standard treatment for recurrent/metastatic head and neck squamous cell carcinoma (RM-SCCHN) is based in on platinum and cetuximab combination therapy. Unfortunately, not all patients are candidates to receive platinum-based treatment, because of different conditions as comorbidity and poor performance status. Weekly paclitaxel and cetuximab (WPC) is an active therapeutic alternative, based on a phase II study, with less toxicity. Our main objective is to confirm its activity in unselected patients, mostly unfit for aggressive therapies, analysing also some clinically relevant prognostic factors (PFs). Retrospective data was collected for RM-SCCHN patients, treated at our institution between January 2008 and July 2014 with weekly paclitaxel (80 mg/m2) and cetuximab (400/250 mg/m2). 148 patients were treated. The objective response rate (OR) was as follows: 13 patients (8.78%) complete response (CR); 57 patients (38.51%) partial response (PR) and 30 patients (20.3%) stable disease (SD). Median overall survival (OS) was 10 months (95% CI 8.31–11.69) and median progression free survival (PFS) was 7 months (95% CI 5.88–8.12). Response to treatment showed independent prognosis relevance as PF in multivariate analysis for PFS and OS. Furthermore, decline in serum magnesium during the treatment was also an independent PF for OS. WPC activity was confirmed as a useful therapy on real-life unselected RM-SCCHN patients, with similar benefit to that obtained in the phase II study, and comparable to platinum and cetuximab based treatment, confirming its value in unfit patients. In addition to treatment response, a change in serum magnesium values during treatment was proved as independent PF on OS.
Databáze: OpenAIRE
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