Improved preservation of larynx with the addition of cetuximab to radiation for cancers of the larynx and hypopharynx

A genetic view of laryngeal cancer heterogeneity

“…87 A subset analysis of the patients with hypopharyngeal and laryngeal tumors showed a preservation hazard ratio (HR) of 0.62 in the cetuximab arm but this was not statistically significant. 88 Regarding ICT, the Veterans study demonstrated 64% preservation larynx rate without worsening survival in the ICT-RT arm compared with surgery-RT. 89 More efficacious induction regimens were further developed and the docetaxel, cisplatin, and 5-Fluorouracil (DCF) schedule became the standard treatment, preserving the larynx 15% more than cisplatin and 5-Fluorouracil.…”

Balancing Safety and Efficacy of Epidermal Growth Factor Receptor Inhibitors in Patients With Squamous Cell Carcinoma of the Head and Neck

“…EGFRIs have been combined with RT as single agents or with cytotoxic chemotherapy in this setting. Table 2 summarizes the relevant published experience with RT plus an EGFRI for the definitive treatment of locoregionally advanced, unresectable SCCHN.The most influential study was the phase III trial by Bonner et al that demonstrated an OS benefit with concurrent RT/cetuximab compared with RT alone (49 vs. 29 months), with a durable OS benefit at 5 years (45.6% vs. 36.4%) [39,40].…”

“…Randomized controlled trials suggest that the addition of an EGFRI to standard therapy affects AE rates only modestly. In the definitive setting, for example, the addition of cetuximab to RT has been associated with a 5% absolute risk increase in the rate of grade $3 radiation dermatitis and a 16% absolute risk increase in the rate of grade $3 acneiform rash compared with RT alone; in contrast, the addition of cetuximab to RT only modestly increases grade $3 mucositis rates compared with RT alone (56% vs. 52%) [39,40]. Rates of grade $3 mucosal toxicity were increased across trials comparing CRT plus EGFRI with CRT alone, including those that evaluated lapatinib (46% Iberri, Colevas vs. 41%) [26], cetuximab (43% vs. 33%) [27], and panitumumab (55% vs. 24%) [31].…”

Swing of the pendulum: Optimizing functional outcomes in larynx cancer

“…Patients treated with radiation therapy and cetuximab had a greater than 9-month improvement in loco-regional control and a greater than 19-month improvement in overall survival, compared with patients treated with radiation alone. However, the study was not powered to determine whether there was a benefit for cetuximab with respect to laryngeal preservation; there was a rate of 87% at 3 years in the 83 patients who received cetuximab and radiotherapy, compared with 77% at 3 years in the 78 patients who received radiotherapy alone [37]. Thus, further prospective trials to determine the efficacy of cetuximab on laryngeal preservation must be performed.…”