Docetaxel, cisplatin and 5-FU compared with docetaxel, cisplatin and cetuximab as induction chemotherapy in advanced squamous cell carcinoma of the head and neck: Results of a randomised phase II AGMT trial

Felix Keil, Maximilian Hartl, Gabriela Altorjai, Andrea Berghold, Regina Riedl, Martin Pecherstorfer, Beate Mayrbäurl, Alexander De Vries, Judith Schuster, Jutta Hackl, Thorsten Füreder, Thomas Melchardt, Martin Burian, Richard Greil

Research output: Journal article (peer-reviewed)Journal article

10 Citations (Scopus)

Abstract

PURPOSE: Induction chemotherapy (ICT) with cisplatin (P), 5-FU (F) and taxanes (T) is a therapeutical option in patients suffering from locally advanced or unresectable stage III or IV squamous cell carcinoma of the head and neck (SCCHN). The role of ICT is controversial, and toxicity and/or delay of radiotherapy (RT) may reduce the potential benefit of this treatment regimen. Here, we report the results of a randomised phase II trial comparing TPF with TP + cetuximab (C).

PATIENTS AND METHODS: In this trial, 100 patients with locally advanced stage III or IV SCCHN were included in the analysis. Patients were randomly assigned to either TPF-ICT (N = 49) or TPC-ICT (N = 51), both followed by RT + C. The primary end-point of the study was overall response rate (ORR) three months after RT + C was finished.

RESULTS: On an intention-to-treat basis, the ORR (complete remission + partial remission) was 74.5% in the TPC arm compared with 63.3% in the TPF arm (p = 0.109). OS was similar in both arms 400 days after treatment was initiated (86.1% [95% confidence interval {CI}, 73.0-93.1%] in the TPC arm and 78.5% [95% CI, 63.7-87.8%] in the TPF arm). TPC resulted in slightly less serious adverse events and in less haematological, but more skin toxicities. Two patients randomised in the TPC arm died during ICT and RT. Four patients in the TPF arm died after completion of RT. No delay from the end of ICT to RT + C was observed. A total of 83.1% of patients (80% in the TPC arm; 86% in the TPF arm) received RT without dose reduction and/or modification.

CONCLUSION: TPC-containing ICT for patients with locally advanced SCCHN was found to be an effective and tolerable one-day regimen. Further prospective evidence from larger trials is warranted.

Original languageEnglish
Pages (from-to)201-210
Number of pages10
JournalEuropean Journal of Cancer
Volume151
DOIs
Publication statusPublished - Jul 2021

Keywords

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols/adverse effects
  • Austria
  • Cetuximab/adverse effects
  • Cisplatin/adverse effects
  • Docetaxel/adverse effects
  • Female
  • Fluorouracil/adverse effects
  • Head and Neck Neoplasms/drug therapy
  • Humans
  • Induction Chemotherapy
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Remission Induction
  • Squamous Cell Carcinoma of Head and Neck/drug therapy
  • Time Factors
  • Treatment Outcome

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