Cisplatin superior to carboplatin in adjuvant radiochemotherapy for locally advanced cancers of the oropharynx and oral cavity

Rades, Dirk; Ulbricht, T. L. V.; Hakim, Samer G.; Schild, Steven E.

doi:10.1007/s00066-011-0005-z

Cited by 28 publications

(36 citation statements)

References 16 publications

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“…Moreover, a randomised non-inferiority trial comparing the use of single agent carboplatin against cisplatin as a radiosensitiser had successfully demonstrated similar survival outcomes [91]; with the reported 3 year OS was 79.2% and 77.7% respectively (p=0.9884, HR 0.83 95% CI 0.613-1.010) [91]. A more recent retrospective study demonstrated significant superiority of cisplatin to carboplatin in terms of adjuvant chemoradiotherapy for locally advanced oropharynx and oral cavity with a 3 year local control rate of 85% versus 62%, 3 year OS of 78% versus 51% and favourable toxicity profile [92] For metastatic/recurrent head and neck cancers, 5-fluorouracil (5-FU) and platinum doublets are well-established standards of care. With respect to comparative studies, Forastiere et al…”

Section: Head and Neck Cancersmentioning

confidence: 56%

Cisplatin versus carboplatin: comparative review of therapeutic management in solid malignancies

Woodward

Coward

2016

Critical Reviews in Oncology/Hematology

248

135

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2 Highlights Platinum analogues, cisplatin and carboplatin, represent some of the most active cytotoxic agents in clinical oncology and are the backbone of most chemotherapeutic regimens  Despite relative similarities in mechanisms of action and activities, there are significant differences in both efficacy and toxicities for both platinum analogues in various malignancies  Carboplatin is a useful alternative in situations where cisplatin is contraindicated and this is not universally at the expense of efficacy  Platinum resistance, both de novo and acquired, is inevitable and understanding the mechanisms of resistance is essential in improving outcomes  Despite the burgeoning era of targeted therapies, the role of efficient DNA damaging agents such as platinum salts remains paramount especially in combination with these novel drugs.3 AbstractThe platinum analogues, cisplatin and carboplatin, are among the most widely used chemotherapeutic agents in oncology. Both agents have a broad spectrum of clinical activity in numerous malignancies including gynaecological cancers, germ cell tumours, head and neck cancer, thoracic cancers and bladder cancer. Although the final mechanism of inducing tumour cell apoptosis is similar for both compounds, cisplatin has been shown to be more effective in treating specific tumour types. Whilst more favourable toxicity profiles are often associated with carboplatin, this can frequently translate to inferior response in certain malignancies. This review succinctly collates the evidence for the preferential use of these platinum analogues in particular settings in addition to the long-standing dilemma surrounding the paucity of biomarkers predicting response to these agents.

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Section: Head and Neck Cancersmentioning

confidence: 56%

Cisplatin versus carboplatin: comparative review of therapeutic management in solid malignancies

Woodward

Coward

2016

Critical Reviews in Oncology/Hematology

248

135

View full text Add to dashboard Cite

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“…Chitapanarux et al [12] compared carboplatin with cisplatin in a prospective randomized trial, finding no difference in the 3-year DFS (p = 0.9613) and OS (p = 0.9884). However, some retrospective analyses found that concurrent carboplatin was a negative prognostic factor for HNSCC and NPC [24,25,26]. Zhang et al [11] reported the use of oxaliplatin for CCRT.…”

Section: Discussionmentioning

confidence: 99%

Pretreatment Epstein-Barr Virus DNA Load and Cumulative Cisplatin Dose Intensity Affect Long-Term Outcome of Nasopharyngeal Carcinoma Treated with Concurrent Chemotherapy: Experience of an Institute in an Endemic Area

Wei

Huang

et al. 2014

Oncol Res Treat

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Background: We retrospectively compared the long-term efficacy of concurrent chemoradiotherapy (CCRT) regimens (docetaxel vs. cisplatin), total dose intensity of cisplatin (> 200 vs. ≤ 200 mg/m²) and pretreatment plasma levels of Epstein-Barr virus (EBV) DNA for nasopharyngeal carcinoma (NPC), and investigated the prognostic factors. Methods: We enrolled 214 patients diagnosed with NPC and treated with CCRT. 41 patients received weekly docetaxel and 173 weekly cisplatin. 62 received cumulative cisplatin of ≤ 200 mg/m² and 111, > 200 mg/m². Pretreatment levels of EBV DNA were available for 155 patients. Results: Patients receiving concurrent weekly docetaxel and cisplatin had similar 5-year rates for overall survival (OS) (p = 0.306), progression-free survival (PFS) (p = 0.133), distant failure-free survival (DFS) (p = 0.110), and locoregional failure-free survival (LFS) (p = 0.452). Cumulative cisplatin of > 200 mg/m² improved the 5-year rates of PFS (p = 0.018) and DFS (p = 0.042) significantly in comparison with cumulative cisplatin of ≤ 200 mg/m². EBV DNA levels of ≥ 1,500 copies/ml was closely associated with poor DFS (p = 0.011), PFS (p = 0.006), and OS (p = 0.004). Conclusions: Weekly cisplatin was well tolerated in CCRT, during which cumulative cisplatin of > 200 mg/m² improved PFS and DFS. The long-term efficacy of concurrent docetaxel was similar to that of concurrent cisplatin. The EBV DNA level was the most significant prognostic factor.

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“…The addition of concurrent chemotherapy to radiotherapy (RT) for LAHNSCC results in an absolute survival benefit of 6.5% at 5-years, with greater benefit with platinum-based chemotherapy [1]. Among the concurrent platinum agents, single-agent cisplatin is superior to single-agent carboplatin and equivalent to carbo-platin with 5-fluorouracil (5FU) in retrospective analyses [2,3]. …”

Section: Introductionmentioning

confidence: 99%

Efficacy of concurrent cetuximab vs. 5-fluorouracil/carboplatin or high-dose cisplatin with intensity-modulated radiation therapy (IMRT) for locally-advanced head and neck cancer (LAHNSCC)

et al. 2014

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Summary Objectives We previously reported inferior outcomes for locally-advanced head and neck squamous cell carcinoma (LAHNSCC) patients treated with concurrent cetuximab vs. high-dose cisplatin with intensity-modulated radiation therapy (IMRT). Prior to FDA approval of cetuximab for LAHNSCC, non-cisplatin eligible patients at our institution received 5-fluorouracil (5FU)/carboplatin. We sought to compare concurrent cetuximab vs. 5FU/carboplatin vs. high-dose cisplatin with IMRT for LAHNSCC. Materials and methods Retrospective review was performed for LAHNSCC patients treated at Memorial Sloan-Kettering Cancer Center from 11/02 to 04/08 with concurrent cetuximab (n = 49), 5FU/carboplatin (n = 52), or cisplatin (n = 259) and IMRT. Overall survival (OS), locoregional failure (LRF), distant metastasis-free survival, and late toxicity were analyzed using univariate and multivariate analyses. OS analysis was confirmed by propensity score adjustment. Results Treatment groups were similar with regard to primary tumor site, overall stage, and alcohol and tobacco history. Cetuximab and 5FU/carboplatin patients were older, with lower performance status, more comorbidities, higher T classification, and worse renal function. On multivariate analysis, compared with cisplatin and 5FU/carboplatin, cetuximab was associated with inferior 4-year OS (86.9% vs. 70.2% vs. 40.9%; P < .0001) and 4-year LRF (6.3% vs. 9.7% vs. 40.2%; P < .0001). Late toxicity was highest with 5FU/carboplatin (25.0%) vs. cisplatin (8.0%) vs. cetuximab (7.7%). Conclusions Although 5FU/carboplatin patients were sicker and experienced greater toxicity than cisplatin patients, no significant difference was found in all endpoints. In contrast, despite similar pretreatment characteristics, outcomes for cetuximab vs. 5FU/carboplatin were significantly worse. We feel that caution should be used with routine use of cetuximab in the management of LAHNSCC.

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Cisplatin superior to carboplatin in adjuvant radiochemotherapy for locally advanced cancers of the oropharynx and oral cavity

Abstract: For adjuvant radiochemotherapy of patients with locally advanced cancer of the oropharynx and oral cavity, cisplatin appears preferable to carboplatin as it resulted in better outcomes without increased toxicity.

Cited by 28 publications

References 16 publications

Cisplatin versus carboplatin: comparative review of therapeutic management in solid malignancies

Cisplatin versus carboplatin: comparative review of therapeutic management in solid malignancies

Pretreatment Epstein-Barr Virus DNA Load and Cumulative Cisplatin Dose Intensity Affect Long-Term Outcome of Nasopharyngeal Carcinoma Treated with Concurrent Chemotherapy: Experience of an Institute in an Endemic Area

Efficacy of concurrent cetuximab vs. 5-fluorouracil/carboplatin or high-dose cisplatin with intensity-modulated radiation therapy (IMRT) for locally-advanced head and neck cancer (LAHNSCC)

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