Efficacy and safety of a cisplatin and paclitaxel induction regimen followed by chemoradiotherapy for patients with locally advanced head and neck squamous cell carcinoma

Viana, Luciano de Souza; Silva, Felipe Coelho de Aguiar; Jácome, Alexandre A.; Maia, Dennys Leite; Mattos, Marcos Duarte de; Jacinto, Alexandre Arthur; Mamere, Augusto Elias; Boldrini, Domingos; Capuzzo, Renato de Castro; Santos, Carlos Roberto dos; Carvalho, André L.

doi:10.1002/hed.24137

Cited by 15 publications

(21 citation statements)

References 62 publications

(169 reference statements)

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“…The protocol is based on induction chemotherapy followed by concomitant chemoradiation; details of the treatment protocol have been previously published [3]. Patients were mainly males (95.8%), with an age range of 40-76 years (median of 56 years).…”

Section: Resultsmentioning

confidence: 99%

“…The organ preservation protocol was based on a protocol used in a phase II clinical trial carried out in our institution; the details of that study were previously published [3]. In summary, the phase II clinical trial was designed to evaluate the feasibility of delivering cisplatin concurrent with radiotherapy after 3 cycles of an induction chemotherapy regimen based on the combination of cisplatin and paclitaxel in advanced HNSCC patients.…”

Section: Methodsmentioning

confidence: 99%

“…For instance, taxanes have been proven to have significant single-agent activity, increasing interest in the incorporation of taxanes into induction regimens for the treatment of patients with locally advanced HNSCC [3]. …”

Section: Introductionmentioning

confidence: 99%

“…The aim of the present study was to evaluate if miRNAs are able to predict the response to an organ preservation protocol based on chemoradiation [3]. For this purpose, we assessed the global miRNA expression profile of HNSCC patients with locally advanced and unresectable tumors undergoing treatment.…”

Section: Introductionmentioning

confidence: 99%

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MiR-21 as prognostic biomarker in head and neck squamous cell carcinoma patients undergoing an organ preservation protocol

et al. 2016

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Despite progress in the treatment of head and neck squamous cell carcinoma (HNSCC) in recent decades, including new surgical techniques, radiotherapy advances and chemotherapy schedules, the prognosis for the affected patients has not improved at the same pace, and still, most HNSCC patients are diagnosed in advanced stages. To increase their survival, the development of better screening methods for early detection is required and appropriate tailored therapeutic interventions are desired. The aim of the present study was to evaluate miRNAs as prognostic biomarkers in patients undergoing organ preservation protocol for locally advanced HNSCC. For this purpose, we assessed the global miRNA expression profile of 15 HNSCC patients (‘screening set’) to identify miRNAs differentially expressed in responders and non-responders to therapy. Four miRNAs differentially expressed in HNSCC samples from the ‘screening set’ were validated in a different cohort of patients (47 samples - ‘validation set’). The results from the ‘validation set’ showed that the higher expression of one of these miRNAs, miR-21, was negatively associated with the treatment response to the organ preservation protocol (p=0.029). A multivariate analysis showed that, in a model adjusted for age, tumor site, p16 immunoexpression and tumor resectability, high expression of miR-21 remained an independent predictor of poor response to the organ preservation protocol (OR=5.69; 95%CI 1.27-25.58; p=0.023), together with clinical stage IV (OR=5.05; 95%CI 1.22-20.88; p=0.025). Furthermore, considering the entire cohort, patients with high expression of miR-21 had worse survival. A multivariate Cox regression analysis also showed miR-21 (HR=2.05; 95%CI 1.05-4.02; p=0.036) and clinical stage IV (HR=3.17; 95%CI 1.49-6.77; p=0.003) as independent prognostic factors (model adjusted for age, tumor site, tumor resectability, and sets ‘screening’ or ‘validation’).In conclusion, the results of this study suggest that the evaluation of miR-21 expression could be an important tool for treatment planning and a prognosis predictior for HNSCC patients undergoing organ preservation protocols.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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MiR-21 as prognostic biomarker in head and neck squamous cell carcinoma patients undergoing an organ preservation protocol

et al. 2016

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“…Hence, 13 studies that recruited a total of 862 patients were deemed eligible and included in this meta‐analysis (Supporting Table SI). Of these, seven studies were analyzed for the primary outcome of response rates and six studies for the secondary outcome of OS. The IC protocols used in these studies were multi‐agent regimes consisting of between two to three chemotherapeutic agents, most commonly taxanes, platinum‐based drugs, and 5‐flourouracil (5FU).…”

Section: Resultsmentioning

confidence: 99%

Meta‐analysis of induction chemotherapy as a selection marker for chemoradiation in the head and neck

et al. 2017

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Objective Many trials incorporate induction chemotherapy (IC) in selecting for organ preservation in head and neck squamous cell carcinomas (HNSCC). However, few studies examine IC response in predicting for chemoradiation therapy (CRT) response. This meta‐analysis aims to determine the predictive accuracy of IC for subsequent response to CRT and overall survival (OS). Data sources Medline, EMBASE, Cochrane register. Methods A systematic search identified studies from database inception to October 2016 that used IC prior to CRT as definitive treatment for advanced HNSCC. The sensitivities and specificities of IC response predicting for complete CRT response were calculated, and the results were pooled in a summary receiver operating curve. One‐, 2‐ and 5‐year OS data were extracted. Results Seven studies (n = 423 patients) were analyzed for response and six (n = 439) for OS. Pooled median sensitivity and specificity of IC response predicting CRT response were 0.95 (95% confidence interval [CI]: 0.72–0.98) and 0.43 (95% CI: 0.00–0.61), respectively. Patients were more likely to respond to CRT given previous response to IC (positive likelihood ratio = 1.6; 95% CI: 1.21–2.11) and less likely to respond to CRT if they failed to respond to IC (negative likelihood ratio = 0.16; 95% CI: 0.07–0.38). At 2 years, good response to IC was a statistically significant prognostic marker with a risk ratio of 1.35 (95% CI: 1.12–1.64). Conclusion Our data suggests that patients with poor IC response will have poorer response to CRT and should be directed to other modalities. In contrast, good IC response does not guarantee a favorable outcome to CRT; however, because these patients are likely to have better prognoses, they should be offered salvage therapies of curative intent despite treatment failure. Level of Evidence NA. Laryngoscope, 128:1594–1601, 2018

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High expression of MLANA in the plasma of patients with head and neck squamous cell carcinoma as a predictor of tumor progression

et al. 2019

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Background There is a paucity of plasma‐based biomarkers that predict outcome in patients with head and neck squamous cell carcinoma (HNSCC) treated with chemoradiation therapy (CRT). Here, we evaluate the prognostic potential of plasma Melanoma‐Antigen Recognized by T‐cells 1 (MLANA) in this setting. Methods MLANA expression in HNSCC lines were evaluated by reverse transcription polymerase chain reaction, whereas plasma levels were quantified using ELISA in 48 patients with locally advanced HNSCC undergoing a phase 2 trial with CRT. Results MLANA is expressed at variable levels in a panel of HNSCC lines. In plasma, levels were elevated in patients with tumor relapse compared to those without (P < .004); 73.9% of the patients expressing high plasma MLANA levels progressed with recurrent disease (P = .020). Multivariate analysis showed that plasma MLANA levels and tumor resectability were independent prognostic factors for progression free survival. Conclusion Plasma MLANA expression appears to be an effective noninvasive biomarker for outcomes in patients treated with CRT, and could potentially guide therapeutic decisions in this context.

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Efficacy and safety of a cisplatin and paclitaxel induction regimen followed by chemoradiotherapy for patients with locally advanced head and neck squamous cell carcinoma

Abstract: Induction TP followed by cisplatin based-CRT was well-tolerated, safe, and had high overall response rate in selected patients with locally advanced HNSCC. © 2015 Wiley Periodicals, Inc. Head Neck 38: E970-E980, 2016.

Cited by 15 publications

References 62 publications

MiR-21 as prognostic biomarker in head and neck squamous cell carcinoma patients undergoing an organ preservation protocol

MiR-21 as prognostic biomarker in head and neck squamous cell carcinoma patients undergoing an organ preservation protocol

Meta‐analysis of induction chemotherapy as a selection marker for chemoradiation in the head and neck

High expression of MLANA in the plasma of patients with head and neck squamous cell carcinoma as a predictor of tumor progression

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