Cetuximab, docetaxel, and cisplatin (TPEx) as first-line treatment in patients with recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN): Final results of phase II trial GORTEC 2008-03.

Authors

Joel Guigay

Joel Guigay

Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France

Joel Guigay , Jerome Fayette , Anne-Francoise Dillies , Christian Sire , Joseph N. Kerger , Isabelle Tennevet , Jean-Pascal H. Machiels , Sylvie Zanetta , Yoann Pointreau , Laurence Bozec Le Moal , Lydia Brugel Ribere , Stefanie Henry , Stéphane Temam

Organizations

Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France, Centre Léon Bérard, Lyon, France, Centre Jean Perrin, Clermont-Ferrand, France, CH de Bretagne Sud, Lorient, France, CHU UCL de Mont-Godinne, Yvoir, Belgium, Centre Henri Becquerel, Rouen, France, Clinique Universitaires St-Luc, Brussels, Belgium, Centre Georges François Leclerc, Dijon, France, CHRU de Tours, Tours, France, Hopital Foch, Suresnes, France, CHIC, Creteil, France, Clinique Sainte-Elisabeth, Namur, Belgium, Institut Gustave Roussy, Villejuif, France

Research Funding

Pharmaceutical/Biotech Company
Background: Cetuximab in combination with platinum and 5FU (PFEx) has become a standard in first-line treatment of patients (pts) with R/M SCCHN. Cetuximab and taxane combinations have shown promising activity. This multicenter phase II study evaluates the efficacy and safety of cetuximab, docetaxel and cisplatin combination (TPEx) as first-line treatment in pts with R/M SCCHN. Methods: Pts were required to have WHO PS 0-1, no prior systemic therapy for R/M SCCHN, cumulative dose of cisplatin less than 300 mg/m² and no prior anti-EGFR therapy. Pts received docetaxel 75 mg/m² day 1, cisplatin 75 mg/m² day 1 and cetuximab (400 mg/m² on day 1 of cycle 1 then 250 mg/m² weekly), repeated every 21 days x 4 cycles then followed by cetuximab 500 mg/m² every 2 weeks (wks) as maintenance therapy until disease progression or unacceptable toxicity. G-CSF support with lenograstim 150 µg/m²/day was delivered after each cycle of chemotherapy. Response was assessed every 6 wks, according to RECIST. The primary endpoint was objective response rate (ORR) at 12 wks. Secondary endpoints were safety, best overall response, progression-free survival (PFS), overall survival (OS) and biomarkers. Results: 54 pts have been enrolled: 52 males, median age 57.8years (28-69), 12 (22.2%) oropharynx, 55% metastatic.48 pts could be evaluated for ORR at 12 wks: partial response, stable disease and progression were respectively found in 23 pts (PR 47.9%), 21 pts (SD 43.7%) and 4 pts (PD 8.3%). Best overall ORR was 54% (1 CR, 27 PR). The median PFS and OS were 7.1 and 15.3 months, respectively. The 1-year OS was 58.6%. Median PFS after start of maintenance therapy was 4.2 months. Toxicity was manageable with G-CSF support. Treatment related toxicities included G4 neutropenia (n=3). Grade 3 events were skin rash (n=5), hypersensitivity reaction (n=3), mucositis (n=1), fatigue (n=1) and febrile neutropenia (n=1). Alopecia was common. 1 toxic death was related to sepsis on feeding tube. Conclusions: Efficacy analysis demonstrates that TPEx regimen is effective and might be a relevant substitute for PFEx as first-line treatment in fit pts with R/M SCCHN.

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Abstract Details

Meeting

2012 ASCO Annual Meeting

Session Type

Oral Abstract Session

Session Title

Head and Neck Cancer

Track

Head and Neck Cancer

Sub Track

Head and Neck Cancer

Clinical Trial Registration Number

NCT01289522

Citation

J Clin Oncol 30, 2012 (suppl; abstr 5505)

DOI

10.1200/jco.2012.30.15_suppl.5505

Abstract #

5505

Abstract Disclosures