Predictors of Outcome With Cetuximab and Paclitaxel for Head and Neck Squamous Cell Carcinoma

被引:7
作者
Ferreira, Bruna Pellini [1 ]
Redman, Mary [2 ]
Baker, Kelsey K. [2 ]
Martins, Renato [3 ]
Eaton, Keith D. [3 ]
Chow, Laura Quan Man [3 ]
Baik, Christina S. [3 ]
Goulart, Bernardo [3 ]
Lee, Sylvia Mina [3 ]
Santana-Davila, Rafael [3 ]
Rodriguez, Cristina P. [3 ]
机构
[1] Univ Cent Florida, Coll Med, Dept Med, Orlando, FL 32816 USA
[2] Fred Hutchinson Canc Res Ctr, Div Clin Res, 1124 Columbia St, Seattle, WA 98104 USA
[3] Univ Washington, Dept Med, Div Med Oncol, Seattle, WA USA
关键词
Cetuximab; paclitaxel; head and neck; squamous cell carcinoma; GROWTH-FACTOR RECEPTOR; PLATINUM-BASED CHEMOTHERAPY; PHASE-II MULTICENTER; RECURRENT/METASTATIC HEAD; ANTIBODY CETUXIMAB; METASTATIC HEAD; PLUS CETUXIMAB; COPY NUMBER; RECURRENT; COMBINATION;
D O I
10.1002/lary.26422
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Objectives: Identify predictors of outcome in patients with recurrent/metastatic head and neck squamous cell carcinoma (RMHNSCC) treated with weekly cetuximab and paclitaxel (CP). Study Design: Retrospective analysis. Methods: Patients with RMHNSCC treated with CP were identified and patient data was recorded. The Kaplan-Meier method was used to estimate outcomes, and Cox regression analysis was used to examine outcome predictors. Results: Fifty-nine patients initiated CP between January 2007 and June 2014. Median age was 56 (range: 39-80) years. The most common primary sites were the oropharynx in 22 (37%) patients, oral cavity in 19 (32%), and larynx in 11 (19%). Eastern Cooperative Oncology Group performance status (ECOG PS) was 0 in seven (12%), 1 in 32 (54%), and 2 in 16 (28%) patients. In 44 (75%) patients, CP was used as a first-line R/M regimen. Median number of cycles was five (range: 1-29). Dose modifications were necessary in 27 (46%) patients. The objective response rate was 47.5%, with 27 (45.8%) partial responses and one (2%) complete response. With a median follow-up of 13.4 months, median progression-free (PFS) and overall survival (OS) were 7.7 and 13.2 months, respectively. On multivariable analysis, an ECOG of 2 of 3 was associated with inferior OS (hazard ratio [HR]: 3.94; P = 0.01; 95% confidence interval [CI]: 1.1-14.04) and PFS (HR: 7.29; P < 0.01; 95% CI: 2.1-26.0) compared to an ECOG 0 of 1. First-line CP administration was associated with superior PFS compared to second line (HR: 2.6; P = 0.02; 95% CI: 1.2-5.5). Conclusions: CP is well tolerated in this population of patients, with favorable tumor efficacy. First-line use and an ECOG 0 of 1 points appears to confer superior outcomes.
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收藏
页码:1583 / 1588
页数:6
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