nab-Paclitaxel-based induction chemotherapy followed by cisplatin and radiation therapy for human papillomavirus-unrelated head and neck squamous-cell carcinoma

Journal Article · Fri Nov 15 04:00:00 EST 2019 · Medical Oncology (Online)

DOI:https://doi.org/10.1007/S12032-019-1318-5· OSTI ID:22938370

Johnson, Kai C. C. ^[1]; Ley, Jessica ^[2]; Oppelt, Peter ^[1]; Lu, Jingxia; Gay, Hiram A.; Daly, Mackenzie; Jackson, Ryan; Rich, Jason; Pipkorn, Patrik; Paniello, Randal C.; Zevallos, Jose; Thorstad, Wade ^[3]

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1. Washington University School of Medicine, Department of Medicine (United States)
2. Washington University School of Medicine, Division of Medical Oncology (United States)
3. Washington University School of Medicine, Alvin J. Siteman Cancer Center (United States)

In patients with locally advanced human papillomavirus (HPV)-unrelated head and neck squamous-cell carcinoma (HNSCC), cisplatin and radiation therapy (CisRT) resulted in a local–regional recurrence (LRR) rate of 35%, progression-free survival (PFS) of 49%, and overall survival (OS) of 60%. We, and others, showed that nab-paclitaxel is an active agent in metastatic and locally advanced HNSCC. The aim of this report was to assess the efficacy of nab-paclitaxel-based induction chemotherapy and CisRT in HPV-unrelated HNSCC. We performed a retrospective single-institution analysis of patients treated with nab-paclitaxel-based chemotherapy and CisRT. Key inclusion criteria included stage III–IV HPV-unrelated HNSCC. Induction chemotherapy included nab-paclitaxel and cisplatin (AP), AP + 5-fluorouracil (APF), or APF + Cetuximab (APF-C). Endpoints included LRR, overall relapse, PFS, and OS. Thirty-eight patients were the subject of this analysis. Patient characteristics included median age 59 years (IQR: 54–64) and smoking history in 36 patients (95%). Primary tumor sites included larynx/hypopharynx (27), p16 negative oropharynx (10), and oral cavity (1). Most patients had bulky disease: 82% T{sub 3–4} (n = 31) and 74% N{sub 2b–3} (n = 28). Median follow-up was 44 months (IQR: 23–59). The three-year LRR rate was 16% (95% confidence interval [CI] 7–34) and the overall relapse rate was 22% (95% CI 11–41). The three-year PFS was 64% (95% CI 46–77) and OS was 72% (95% CI 54–84). Among patients with HPV-unrelated HNSCC, nab-paclitaxel-based induction chemotherapy and CisRT resulted in a lower-than-expected rate of LRR and more favorable PFS and OS compared to historical results with CisRT.

• OSTI ID: 22938370
• Journal Information: Medical Oncology (Online), Journal Name: Medical Oncology (Online) Journal Issue: 11 Vol. 36; ISSN 1559-131X
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
CHEMOTHERAPY
FLUOROURACILS
HEAD
LARYNX
METASTASES
NECK
ORAL CAVITY
PATIENTS
RADIOTHERAPY
SMOKES