Cetuximab with docetaxel a safe alternative to cisplatin for head and neck cancer
Cetuximab and docetaxel is safe and effective during postoperative radiotherapy for high-risk head and neck cancer patients who cannot receive cisplatin, a new study has found.
Over a median follow-up period of 22 months, the 1- and 2-year disease-free survival rates in 11 head and neck cancer patients were 91 and 55 percent, respectively.
Of the five deaths, only one was because of other diseases while the other four were because of cancer. Three of the four cancer-related deaths involved metastasis or lymph node recurrence.
Grade 3 severe adverse events were observed in seven of the 11 cases. Of these, grade 3 oral mucositis was the most common adverse event, present in five cases. This was followed by aspiration (n=3), radiation dermatitis (n=2), reduced white blood cells (n=1), lower neutrophil counts (n=1), lung infection (n=1) and hyponatraemia (n=1).
Grade 2 pulmonary fibrosis was observed in one case, while no grade 4 severe adverse events were recorded.
During the postoperative biochemoradiotherapy, all patients tested positive for Methicillin-resistant Staphylococcus aureus which manifested as pneumonia in three patients; the remaining eight patients were asymptomatic.
The study included 11 patients with histologically confirmed stage III to IVB head and neck cancer. Participants had no exposures to prior treatment, underwent resection, and had a primary tumour in the larynx, nasal cavity, paranasal cavity, oropharynx, oral cavity or hypopharynx.
Radiation was delivered five times a week at 1.8-Gy doses, reaching a total of 66.6 Gy of radiation per week. Cetuximab and docetaxel were administered weekly.