A comparison of concurrent cisplatin versus cetuximab with radiotherapy in locally-advanced head and neck cancer: A bi-institutional analysis

Stokes, William A.; Sumner, Whitney; Breggren, Kiersten L.; Rathbun, John Tyler; Raben, David; McDermott, Jessica D.; Gan, Gregory N.; Karam, Sana D.

doi:10.1016/j.rpor.2017.07.003

Cited by 10 publications

(6 citation statements)

References 36 publications

(47 reference statements)

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“…OS overall survival, CRT radiochemoradiotherapy with cisplatin, RIT radioimmunotherapy with cetuximab, RT radiotherapy not give recommendations on preferred treatment options but aimed at prospectively documenting current treatment strategies for advanced SCCHN in different tertiary cancer centers around the country. Thus, we report an unselected cohort of patients with distribution of age, primary tumor site and stage similar to recent literature [11,15]. The majority of patients within the registry were treated with postoperative or definitive CRT or RIT.…”

Section: Discussionmentioning

confidence: 86%

“…In these patients, other radiosensitizing strategies including monoclonal antibodies, such as cetuximab, which has a more favorable safety profile than cisplatin, might be an attractive option. In fact, the superior efficacy of definitive radioimmunotherapy (RIT) with cetuximab compared to definitive radiotherapy (RT) alone was shown in a randomized phase III trial [8]; however, CRT with cisplatin has already been shown to be superior to RIT with cetuximab in a definitive setting through various prospective and retrospective studies [9][10][11]. In the postoperative setting, the monoclonal antibody has not yet been extensively studied or compared to adjuvant CRT with cisplatin or radiotherapy alone and is therefore not approved.…”

Section: Introductionmentioning

confidence: 99%

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Postoperative chemoradiotherapy with cisplatin is superior to radioimmunotherapy with cetuximab and radiotherapy alone

Magnes

Wagner

Melchardt

et al. 2021

Wien Klin Wochenschr

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Summary Background The addition of cisplatin or cetuximab to radiotherapy in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) has significantly improved the outcome. While the superiority of cisplatin over cetuximab in combination with radiotherapy has been shown in a definitive setting, we set out to compare postoperative chemoradiotherapy with cisplatin to radioimmunotherapy with cetuximab and radiotherapy alone within the Austrian head and neck cancer registry of the Working Group on Pharmaceutical Tumor Treatment (AGMT) study group. Material and methods In the AGMT head and neck cancer registry, data of 557 patients with SCCHN from five Austrian cancer centers were prospectively collected between 2012 and 2017. Of these patients 120 received postoperative chemoradiotherapy with cisplatin, 26 patients received postoperative radioimmunotherapy with cetuximab and 56 patients were treated with adjuvant radiotherapy only. Patient characteristics, stage of disease, details on treatment as well as survival were analyzed by a chart-based review. Results In patients treated with postoperative radiotherapy the addition of cisplatin significantly improved progression-free survival (PFS) and overall survival (OS) compared to cetuximab (PFS 84.2 months vs. 17.0 months, p = 0.04, OS not reached vs. 46.0 months, p = 0.02) and PFS compared to radiotherapy alone (PFS 84.2 months vs. 28.5 months, p < 0.01). Patients treated with cetuximab were significantly older and had a worse performance score than patients receiving cisplatin or radiotherapy alone. Conclusion This study confirmed the importance of multimodal treatment concepts in patients with locally advanced SCCHN. Postoperative cetuximab might be an option in patients not eligible for high-dose cisplatin but cisplatin should remain the standard of care.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Postoperative chemoradiotherapy with cisplatin is superior to radioimmunotherapy with cetuximab and radiotherapy alone

Magnes

Wagner

Melchardt

et al. 2021

Wien Klin Wochenschr

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“…Our finding is supported by similar data [ 20 , 44 ], which confirmed that toxicity of platinum derivates and cetuximab is comparable. However, other authors have shown that BRT with cetuximab resulted in poorer overall survival, progression-free survival, locoregional control, and distant metastasis-free survival than cisplatin-based therapy [ 11 , 20 , 45 ]. Altogether, these results practically reduce the value of cetuximab in the treatment of advanced HNC, but cetuximab still remains a valuable option for patients with contraindications to platinum-based therapy.…”

Section: Discussionmentioning

confidence: 99%

Nutritional Care in Patients with Head and Neck Cancer during Chemoradiotherapy (CRT) and Bioradiotherapy (BRT) Provides Better Compliance with the Treatment Plan

Kapała

Surwiłło-Snarska

Jodkiewicz

et al. 2021

Cancers

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The treatment of locally advanced head and neck cancer (HNC) is based on extensive resections followed by concurrent chemoradiotherapy (CRT) with platinum derivatives or concurrent radiotherapy with cetuximab (bioradiotherapy; BRT). Malnutrition, which occurs in up to 60% of patients before treatment commencement, severely increases the risk of CRT/BRT drug dose reductions and the incidence of treatment-related adverse events. A prospective observational study was performed regarding the influence of nutritional care on nutritional status, compliance with the treatment‘s planned regimen, and the incidence of treatment-related complications in patients with advanced HNC during CRT and BRT. The study population encompassed 153 patients compared with a retrospective control group of 72 patients treated before nutritional care was included in the standard of oncological care. Patients enrolled in the nutritional care programme received significantly higher doses of platinum derivatives or cetuximab than patients in the control group. A significant difference between the compared populations was observed in patients below 70 years of age (92.8% of the study population), after prior surgery, and with initial weight loss lower than 10%. Nutritional care reduced final weight loss and prevented a decline within the laboratory markers of nutritional status. Weight loss was comparable in both modes of treatment—CRT and BRT. The incidence of treatment-related complications was significantly higher in patients without nutritional support in the subgroups of patients under 70 years of age and after primary surgery. Nutritional care before and during CRT and BRT in patients with HNC is a determinant of therapeutic benefit, defined as preventing down-dosing, weight loss, and the incidence of complications. Platinum derivatives and cetuximab had comparable influence on weight loss.

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“…For the majority of cases, the standard procedure includes platin-based chemotherapy and subsequent irradiation [41]. Unfortunately, the activity of cisplatin is not specific towards cancer cells, which are more susceptible than healthy counterparts only because of their higher proliferation rate [42]. This lack of selective targeting corresponds with high toxicity of therapy and the incidence of serious adverse effects, which not only decreases the quality of life but might trigger severe complications [43].…”

Section: Discussionmentioning

confidence: 99%

Fucoidan Exerts Anticancer Effects Against Head and Neck Squamous Cell Carcinoma In Vitro

et al. 2018

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Fucoidans have been reported to exert anticancer effects with simultaneous low toxicity against healthy tissue. That correlation was observed in several cancer models, however, it has never been investigated in head and neck cancer before. To magnify the efficacy of conventional therapy, the administration of agents like fucoidan could be beneficial. The aim of this study was to evaluate the anticancer effect of Fucus vesiculosus (FV) extract alone and with co-administration of cisplatin in head and neck squamous cell carcinoma (HNSCC) in vitro. MTT assay results revealed an FV-induced inhibition of proliferation in all tested cell lines (H103, FaDu, KB). Flow cytometric cell cycle analysis showed an FV-induced, dose-dependent arrest in either S/G2 phase (H103, FaDu) or G1 arrest (KB). Furthermore, a dose-dependent gain in apoptotic fraction was observed. Western blot analysis confirmed the induction of apoptosis. A significant dose-dependent increase in reactive oxygen species (ROS) production was revealed in the H103 cell line, while FaDu cells remained unresponsive. On the contrary, an HPV-positive cell line, KB, demonstrated a dose-dependent decrease in ROS synthesis. Moreover, fucoidan enhanced the response to cisplatin (synergistic effect) in all cell lines with the HPV-positive one (KB) being the most sensitive. These results have been confirmed by flow-cytometric apoptosis analysis. In conclusion, we confirmed that fucoidan exhibits anticancer properties against HNSCC, which are manifested by the induction of apoptosis, regulation of ROS production, cell cycle arrest, and inhibition of proliferation.

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A comparison of concurrent cisplatin versus cetuximab with radiotherapy in locally-advanced head and neck cancer: A bi-institutional analysis

Abstract: In our retrospective analysis, patients undergoing CRT experienced improved OS and CSS over those receiving BRT; however, disease control did not significantly differ. These findings may inform management of LAHNSCC patients.

Cited by 10 publications

References 36 publications

Postoperative chemoradiotherapy with cisplatin is superior to radioimmunotherapy with cetuximab and radiotherapy alone

Postoperative chemoradiotherapy with cisplatin is superior to radioimmunotherapy with cetuximab and radiotherapy alone

Nutritional Care in Patients with Head and Neck Cancer during Chemoradiotherapy (CRT) and Bioradiotherapy (BRT) Provides Better Compliance with the Treatment Plan

Fucoidan Exerts Anticancer Effects Against Head and Neck Squamous Cell Carcinoma In Vitro

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