Combined Modality Treatment With Chemotherapy, Radiation Therapy, Bevacizumab, and Erlotinib in Patients With Locally Advanced Squamous Carcinoma of the Head and Neck

Hainsworth, John D.; Spigel, David R.; Greco, F. Anthony; Shipley, Dianna; Peyton, James D.; Rubin, Mark; Stipanov, Michael; Meluch, A. A.

doi:10.1097/ppo.0b013e3182329791

Cited by 62 publications

(43 citation statements)

References 20 publications

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“…However the most feared side effects, above all in HNC, are idiosyncratic bleeding events, wound and ulcer healing complications, and gastrointestinal perforations, which can be fatal. In the phase II trial by Hainsworth et al, a fatal cerebral-vascular accident , grade3-4 mucosal toxicity in 78 pts% and nearly half of the population that needed enteral or parenteral alimentation during treatment with erlotinib bevacizumab and paclitaxel were registered [24]. The same Bevacizumab toxicity profile was confirmed with a 15% Grade 3 to 5 bleeding events, including 2 fatal events by Argiris et al [28].…”

Section: Angiogenic Therapies Toxicitiessupporting

confidence: 48%

“…In this study patients received 6 weeks of neoadjuvant chemotherapy/Bevacizumab followed by concurrent CRT with weekly Paclitaxel, Bevacizumab (3 weekly) and daily Erlotinib (150 mg). Although the median progression free and overall survival rates have not been reached, the authors point out a 3 years estimated progression free and overall survival rates of 71 and 85%, respectively [24].…”

Section: Seiwert Et Al Reported Enthusiastic Results Of the Combinatmentioning

confidence: 99%

“…In our opinion the relevance of antiangiogenic therapy remains largely under evaluated in clinical trials. New antiangiogenic drugs (Cediranib Hainsworth et al [40] 60 Beva-5FU-PTX-CDDP RT+ Beva-erlotinib+ PTX 3y 71% 3y OS 82% A better definition of predictive factors of response and an improvement of safety profile may help to establish exactly the importance of antiangiogenic drugs in this heterogeneous tumor. Continued investigations and the collaborative effort of all physicians caring for head and neck cancer patients will be necessary to determine if antiangiogenic approaches will ultimately improve survival.…”

Section: Discussion Present and Future Prospectivementioning

confidence: 99%

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Angiogenesis in Head and Neck Cancer

EG¹

2014

J Cancer Sci Ther

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Locally advanced Head and Neck Squamous Cell Carcinoma (HNC) is a challenging disease for the lack of effective therapies even in the era of molecular medicine (the five-year survival does not exceed 40%). For patients with metastatic and recurrent HNC the standard treatment is the combination of Cetuximab/Platinum and Fluorouracil but median overall survival rate for this population remains lower than 11%. The main reasons of these disappointing outcomes include acquired drug resistance, anti Epidermal growth factors variants, epithelial to mesenchymal transition and tumor hypoxia.Angiogenesis plays a crucial role in HNSCC development and proliferation. Drugs may interfere with the angiogenic process via different mechanisms and there is a sound rationale for combining anti-angiogenic agents with chemotherapy or multiple anti-angiogenic strategies. Promising preclinical results with angiogenic inhibitors have engendered a number of trials, but until now there are not yet conclusive data on the value of anti-angiogenic therapy in HNC.

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Section: Angiogenic Therapies Toxicitiessupporting

confidence: 48%

Section: Seiwert Et Al Reported Enthusiastic Results Of the Combinatmentioning

confidence: 99%

Section: Discussion Present and Future Prospectivementioning

confidence: 99%

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Angiogenesis in Head and Neck Cancer

EG¹

2014

J Cancer Sci Ther

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“…Hainsworth et al evaluated the feasibility and efficacy of adding both bevacizumab and erlotinib to concurrent chemoradiation (CRT) as a first-line treatment in locally advanced SCCHN. The 3-year progression-free survival rate and the overall survival rate for the entire group were respectively 71% and 85% and the most frequent severe toxicity was grade 3/4 mucosal toxicity [19]. Several other studies investigated the safety and efficacy of erlotinib combined with concurrent chemoradiation, but their sample size was too small to allow for any significant conclusions [18,36].…”

Section: Tyrosine Kinase Inhibitorsmentioning

confidence: 99%

“…Several clinical studies have yielded positive results when using a combination of bevacizumab, cetuximab, and chemotherapy in addition to radiation or when adding bevacizumab to the combination of erlotinib, chemotherapy, and radiation [17][18][19]. Further exploration of these combined strategies and their safety profiles thus seems like a promising direction to pursue.…”

Section: Promising Trials and Next Steps To Overcome Resistancementioning

confidence: 99%

Radiotherapy plus EGFR inhibitors: synergistic modalities

Bossi

Platini

2017

Cancers Head Neck

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Locally advanced (stage III or IV) squamous cell carcinoma of the head and neck (SCCHN) often requires multimodal treatment, consisting of a combination of surgery, radiation, and/or systemic therapy, namely chemotherapy or targeted agents. The expression of the epidermal growth factor receptor (EGFR) has been detected in more than 90% of all cases of SCCHN and has been correlated with decreased survival rates, resistance to radiotherapy, loco-regional treatment failure, and increased rates of distant metastases. This paper discusses several strategies aimed at targeting EGFR in combination with radiation. Until now, cetuximab, an anti-EGFR monoclonal antibody, is the only targeted agent that has been shown to improve overall survival in combination with radiation therapy. However, considering that there are multiple mechanisms of primary and acquired resistance to EGFR inhibitors, we focused on dissecting molecular pathways of EGFR inhibition to find alternative or complementary strategies for increasing tumour responsiveness. We suggest that the combination of treatments targeting the EGFR pathway and drugs aimed at increasing immune responses represent a promising approach that deserves to be further explored.

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Monoclonal antibodies for the treatment of squamous cell carcinoma: A literature review

Tamimi

Sorkheh

et al. 2023

Cancer Reports

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Background Squamous cell carcinoma (SCC) is a relatively common and heterogenous malignancy of different organs, such as the skin, esophagus, and lungs. Although most cases experience good survival with surgical methods, management of advanced types of the disease remains challenging. Several modalities, including different chemotherapy regimens and immunotherapies, have been investigated in this matter, among which Monoclonal antibodies (Mabs) are one of the most promising ones. Since the development of Mabs, they have been widely used to treat different diseases. Mabs have shown significant efficacy with high specificity along with acceptable safety, which makes them a favorable option in cancer therapy. In this article, we aimed to review the different aspects of using Mabs in SCC therapy. Recent Findings We found that treating with different Mabs has shown excellent efficacy accompanied by acceptable safety in treating SCC of different organs. Therefore, Mabs are considered great options in the treatment of SCC, especially in advanced cases. Overall, two highly potent types of Mabs in SCC therapy are anti‐EGFR Mabs and checkpoint inhibitors, especially Cetuximab, Nimotuzumab, and PD‐1 inhibitors. Bevacizumab is also a promising option as adjuvant therapy to other modalities. Conclusion Although some Mabs have shown promising outcomes in SCC therapy, their application as a part of cancer treatment depends on further investigations regarding cost‐effectiveness and predictors of response. FDA has approved several Mabs in SCC therapies, and Mabs may have a crucial role in this era in the near future, especially in treating head and neck and esophageal SCC and metastatic lung cancer.

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Combined Modality Treatment With Chemotherapy, Radiation Therapy, Bevacizumab, and Erlotinib in Patients With Locally Advanced Squamous Carcinoma of the Head and Neck

Cited by 62 publications

References 20 publications

Angiogenesis in Head and Neck Cancer

Angiogenesis in Head and Neck Cancer

Radiotherapy plus EGFR inhibitors: synergistic modalities

Monoclonal antibodies for the treatment of squamous cell carcinoma: A literature review

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