Activity of weekly paclitaxel−cetuximab chemotherapy in unselected patients with recurrent/metastatic head and neck squamous cell carcinoma: prognostic factors
Background 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 po...
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| Veröffentlicht in: | Clinical & translational oncology 2017-06, Vol.19 (6), p.769-776 |
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| creator | Bernad, I. Pajares Trufero, J. Martínez Urquizu, L. Calera Pazo Cid, R. A. de Miguel, A. Cebollero Agustin, M. J. Lanzuela, M. Antón, A. |
| description | Background
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).
Methods
Retrospective data was collected for RM-SCCHN patients, treated at our institution between January 2008 and July 2014 with weekly paclitaxel (80 mg/m
2
) and cetuximab (400/250 mg/m
2
).
Results
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.
Conclusions
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. |
| doi_str_mv | 10.1007/s12094-016-1604-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1861868051</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1861868051</sourcerecordid><originalsourceid>FETCH-LOGICAL-c344t-d82fa6f4009be5895be216e16096ef35bb6b2441798b3980a55c9bd2bf3793eb3</originalsourceid><addsrcrecordid>eNp9UUFOGzEUtSqqBmgP0E3lZTdD7BmPM-4OIQpIkdi0UneW7fmTGGbsxPYAyQm65gZcjZPgKGmXSJa-_f97T8__IfSVkjNKyGwaaUkEKwjlBeWEFdsP6JhyIYqK1PXR4U5Y82eCTmK8I7nLKf2EJmWTmVXJjtHLuUn2waYN9h1-BLjvN3ilTG-TeoL-9e-zgTQ-2UFpbJYw-LSEoFYbbB0eXYQeTII2M5IFlyJ-tGmJA5gxhPyeDpBUTHlo8BJUi5VrsQNzj-N6VIMfIzbQ99ioYKzzg_qBV8EvnI87RqdM8iF-Rh871Uf4cqin6PfPy18X18X89urm4nxemIqxVLRN2SneMUKEhroRtYaScsh7ERy6qtaa65IxOhONrkRDVF0bodtSd9VMVKCrU_R9r5strEeISQ427uwpB9mppA3PpyE1zVC6h5rgYwzQyVXIKwobSYncJSP3ycicjNwlI7eZ8-0gP-oB2v-Mf1FkQLkHxDxyCwjyzo_B5S-_o_oGQ_qfvA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1861868051</pqid></control><display><type>article</type><title>Activity of weekly paclitaxel−cetuximab chemotherapy in unselected patients with recurrent/metastatic head and neck squamous cell carcinoma: prognostic factors</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Bernad, I. Pajares ; Trufero, J. Martínez ; Urquizu, L. Calera ; Pazo Cid, R. A. ; de Miguel, A. Cebollero ; Agustin, M. J. ; Lanzuela, M. ; Antón, A.</creator><creatorcontrib>Bernad, I. Pajares ; Trufero, J. Martínez ; Urquizu, L. Calera ; Pazo Cid, R. A. ; de Miguel, A. Cebollero ; Agustin, M. J. ; Lanzuela, M. ; Antón, A.</creatorcontrib><description>Background
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).
Methods
Retrospective data was collected for RM-SCCHN patients, treated at our institution between January 2008 and July 2014 with weekly paclitaxel (80 mg/m
2
) and cetuximab (400/250 mg/m
2
).
Results
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.
Conclusions
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.</description><identifier>ISSN: 1699-048X</identifier><identifier>EISSN: 1699-3055</identifier><identifier>DOI: 10.1007/s12094-016-1604-z</identifier><identifier>PMID: 28120324</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Carcinoma, Squamous Cell - drug therapy ; Carcinoma, Squamous Cell - mortality ; Cetuximab - administration & dosage ; Disease-Free Survival ; Female ; Head and Neck Neoplasms - drug therapy ; Head and Neck Neoplasms - mortality ; Humans ; Kaplan-Meier Estimate ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Recurrence, Local - drug therapy ; Oncology ; Paclitaxel - administration & dosage ; Prognosis ; Proportional Hazards Models ; Research Article ; Retrospective Studies ; Squamous Cell Carcinoma of Head and Neck ; Treatment Outcome</subject><ispartof>Clinical & translational oncology, 2017-06, Vol.19 (6), p.769-776</ispartof><rights>Federación de Sociedades Españolas de Oncología (FESEO) 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c344t-d82fa6f4009be5895be216e16096ef35bb6b2441798b3980a55c9bd2bf3793eb3</citedby><cites>FETCH-LOGICAL-c344t-d82fa6f4009be5895be216e16096ef35bb6b2441798b3980a55c9bd2bf3793eb3</cites><orcidid>0000-0003-4825-4977</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12094-016-1604-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12094-016-1604-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28120324$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bernad, I. Pajares</creatorcontrib><creatorcontrib>Trufero, J. Martínez</creatorcontrib><creatorcontrib>Urquizu, L. Calera</creatorcontrib><creatorcontrib>Pazo Cid, R. A.</creatorcontrib><creatorcontrib>de Miguel, A. Cebollero</creatorcontrib><creatorcontrib>Agustin, M. J.</creatorcontrib><creatorcontrib>Lanzuela, M.</creatorcontrib><creatorcontrib>Antón, A.</creatorcontrib><title>Activity of weekly paclitaxel−cetuximab chemotherapy in unselected patients with recurrent/metastatic head and neck squamous cell carcinoma: prognostic factors</title><title>Clinical & translational oncology</title><addtitle>Clin Transl Oncol</addtitle><addtitle>Clin Transl Oncol</addtitle><description>Background
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).
Methods
Retrospective data was collected for RM-SCCHN patients, treated at our institution between January 2008 and July 2014 with weekly paclitaxel (80 mg/m
2
) and cetuximab (400/250 mg/m
2
).
Results
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.
Conclusions
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.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Carcinoma, Squamous Cell - drug therapy</subject><subject>Carcinoma, Squamous Cell - mortality</subject><subject>Cetuximab - administration & dosage</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Head and Neck Neoplasms - drug therapy</subject><subject>Head and Neck Neoplasms - mortality</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - drug therapy</subject><subject>Oncology</subject><subject>Paclitaxel - administration & dosage</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Research Article</subject><subject>Retrospective Studies</subject><subject>Squamous Cell Carcinoma of Head and Neck</subject><subject>Treatment Outcome</subject><issn>1699-048X</issn><issn>1699-3055</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UUFOGzEUtSqqBmgP0E3lZTdD7BmPM-4OIQpIkdi0UneW7fmTGGbsxPYAyQm65gZcjZPgKGmXSJa-_f97T8__IfSVkjNKyGwaaUkEKwjlBeWEFdsP6JhyIYqK1PXR4U5Y82eCTmK8I7nLKf2EJmWTmVXJjtHLuUn2waYN9h1-BLjvN3ilTG-TeoL-9e-zgTQ-2UFpbJYw-LSEoFYbbB0eXYQeTII2M5IFlyJ-tGmJA5gxhPyeDpBUTHlo8BJUi5VrsQNzj-N6VIMfIzbQ99ioYKzzg_qBV8EvnI87RqdM8iF-Rh871Uf4cqin6PfPy18X18X89urm4nxemIqxVLRN2SneMUKEhroRtYaScsh7ERy6qtaa65IxOhONrkRDVF0bodtSd9VMVKCrU_R9r5strEeISQ427uwpB9mppA3PpyE1zVC6h5rgYwzQyVXIKwobSYncJSP3ycicjNwlI7eZ8-0gP-oB2v-Mf1FkQLkHxDxyCwjyzo_B5S-_o_oGQ_qfvA</recordid><startdate>20170601</startdate><enddate>20170601</enddate><creator>Bernad, I. Pajares</creator><creator>Trufero, J. Martínez</creator><creator>Urquizu, L. Calera</creator><creator>Pazo Cid, R. A.</creator><creator>de Miguel, A. Cebollero</creator><creator>Agustin, M. J.</creator><creator>Lanzuela, M.</creator><creator>Antón, A.</creator><general>Springer International Publishing</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4825-4977</orcidid></search><sort><creationdate>20170601</creationdate><title>Activity of weekly paclitaxel−cetuximab chemotherapy in unselected patients with recurrent/metastatic head and neck squamous cell carcinoma: prognostic factors</title><author>Bernad, I. Pajares ; Trufero, J. Martínez ; Urquizu, L. Calera ; Pazo Cid, R. A. ; de Miguel, A. Cebollero ; Agustin, M. J. ; Lanzuela, M. ; Antón, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c344t-d82fa6f4009be5895be216e16096ef35bb6b2441798b3980a55c9bd2bf3793eb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Carcinoma, Squamous Cell - drug therapy</topic><topic>Carcinoma, Squamous Cell - mortality</topic><topic>Cetuximab - administration & dosage</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Head and Neck Neoplasms - drug therapy</topic><topic>Head and Neck Neoplasms - mortality</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - drug therapy</topic><topic>Oncology</topic><topic>Paclitaxel - administration & dosage</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Research Article</topic><topic>Retrospective Studies</topic><topic>Squamous Cell Carcinoma of Head and Neck</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bernad, I. Pajares</creatorcontrib><creatorcontrib>Trufero, J. Martínez</creatorcontrib><creatorcontrib>Urquizu, L. Calera</creatorcontrib><creatorcontrib>Pazo Cid, R. A.</creatorcontrib><creatorcontrib>de Miguel, A. Cebollero</creatorcontrib><creatorcontrib>Agustin, M. J.</creatorcontrib><creatorcontrib>Lanzuela, M.</creatorcontrib><creatorcontrib>Antón, A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical & translational oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bernad, I. Pajares</au><au>Trufero, J. Martínez</au><au>Urquizu, L. Calera</au><au>Pazo Cid, R. A.</au><au>de Miguel, A. Cebollero</au><au>Agustin, M. J.</au><au>Lanzuela, M.</au><au>Antón, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Activity of weekly paclitaxel−cetuximab chemotherapy in unselected patients with recurrent/metastatic head and neck squamous cell carcinoma: prognostic factors</atitle><jtitle>Clinical & translational oncology</jtitle><stitle>Clin Transl Oncol</stitle><addtitle>Clin Transl Oncol</addtitle><date>2017-06-01</date><risdate>2017</risdate><volume>19</volume><issue>6</issue><spage>769</spage><epage>776</epage><pages>769-776</pages><issn>1699-048X</issn><eissn>1699-3055</eissn><abstract>Background
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).
Methods
Retrospective data was collected for RM-SCCHN patients, treated at our institution between January 2008 and July 2014 with weekly paclitaxel (80 mg/m
2
) and cetuximab (400/250 mg/m
2
).
Results
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.
Conclusions
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.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>28120324</pmid><doi>10.1007/s12094-016-1604-z</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-4825-4977</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical & translational oncology, 2017-06, Vol.19 (6), p.769-776 |
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| subjects | Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols - therapeutic use Carcinoma, Squamous Cell - drug therapy Carcinoma, Squamous Cell - mortality Cetuximab - administration & dosage Disease-Free Survival Female Head and Neck Neoplasms - drug therapy Head and Neck Neoplasms - mortality Humans Kaplan-Meier Estimate Male Medicine Medicine & Public Health Middle Aged Neoplasm Recurrence, Local - drug therapy Oncology Paclitaxel - administration & dosage Prognosis Proportional Hazards Models Research Article Retrospective Studies Squamous Cell Carcinoma of Head and Neck Treatment Outcome |
| title | Activity of weekly paclitaxel−cetuximab chemotherapy in unselected patients with recurrent/metastatic head and neck squamous cell carcinoma: prognostic factors |
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