Multicenter, Phase II Study of Cetuximab in Combination With Carboplatin in Patients With Recurrent or Metastatic Nasopharyngeal Carcinoma

Chan, Anthony Tak-cheung; Hsu, Ming‐Hsi; Goh, Boon Cher; Hui, Edwin P.; Liu, Tsang Wu; Millward, Michael; Hong, Ruey‐Long; Whang‐Peng, Jacqueline; B.Y., Brigette; To, Ka Fai; Mueser, M.; Amellal, Nadia; Lin, Xiao; Chang, Alex Y.

doi:10.1200/jco.2005.02.147

Cited by 267 publications

(175 citation statements)

References 29 publications

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“…Another phase 2 trial tested it in combination with cetuximab, a targeted therapy against epidermal growth factor receptor which is expressed in most NPCs, in patients who had progressed on or within 12 months after termination of platinum based chemotherapy for recurrent or metastatic NPC. This trial yielded a response rate of 11.7% and the authors concluded that this combination demonstrated clinical activity with an acceptable toxicity profile in a heavily pretreated population (Chan et al, 2005). More recently, carboplatin has been compared to CDDP in the definitive setting with chemoirradiation for locally advanced NPC.…”

Section: Introductionmentioning

confidence: 99%

Carboplatin/5-fluorouracil as an Alternative to Cisplatin/5-Fluorouracil for Metastatic and Recurrent Head and Neck Squamous Cell Carcinoma and Nasopharyngeal Carcinoma

Kua

Ismail²,

Phua

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: Palliative chemotherapy with cisplatin/5-fluorouracil (5FU) is the commonest regimen employed for metastatic and recurrent head and neck squamous cell carcinoma (SCCHN) and nasopharyngeal carcinoma (NPC). However, this regimen is cumbersome requiring 5 days of admission to hospital. Carboplatin/5FU may be an alternative regimen without compromising survival and response rates. This study aimed to compare the efficacy and toxicity of carboplatin/5FU regimen with the cisplatin/5FU regimen. Materials and Methods: This retrospective study looked at patients who had palliative chemotherapy with either cisplatin/5FU or carboplatin/5FU for metastatic and recurrent SCCHN and NPC. It included patients who were treated at UKMMC from 1 st January 2004 to 31 st December 2009 with either palliative IV cispaltin 75 mg/m 2 D1 only plus IV 5FU 750 mg/m 2 D1-5 infusion or IV Carboplatin AUC 5 D1 only plus IV 5FU 500 mg/m 2 D1-2 infusion plus IV 5FU 500 mg/m 2 D1-2 bolus. The specific objectives were to determine the efficacy of palliative chemotherapy in terms of overall response rate (ORR), median progression free survival (PFS) and median overall survival (OS) and to evaluate the toxicities of both regimens. Results: A total of 41 patients were eligible for this study. There were 17 in the cisplatin/5FU arm and 24 in the carboplatin/5FU arm. The ORR was 17.7 % for cisplatin/5FU arm and 37.5 % for carboplatin/5FU arm (p-value=0.304). The median PFS was 7 months for cisplatin/5FU and 9 months for carboplatin/5FU (p-value=1.015). The median OS was 10 months for cisplatin/5FU arm and 12 months for carboplatin/5FU arm (p-value=0.110). There were 6 treatment-related deaths (6/41=14.6%), four in the carboplatin/5FU arm (4/24=16.7%) and 2 in the cisplatin/5FU arm (2/17=11.8%). Grade 3 and 4 hematologic toxicity was also more common with carboplatin/5FU group, this difference being predominantly due to grade 3-4 granulocytopenia (41.6% vs. 0), grade 3-4 anemia (37.5% vs. 0) and grade 3-4 thrombocytopenia (16.6% vs. 0). Conclusions: Carboplatin/5FU is not inferior to cisplatin/5FU with regard to its efficacy. However, there was a high rate of treatment-related deaths with both regimens. A better alternative needs to be considered.

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Section: Introductionmentioning

confidence: 99%

Carboplatin/5-fluorouracil as an Alternative to Cisplatin/5-Fluorouracil for Metastatic and Recurrent Head and Neck Squamous Cell Carcinoma and Nasopharyngeal Carcinoma

Kua

Ismail²,

Phua

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…11 EGFR monoclonal antibody, cetuximab (C225), had demonstrated a gratifying survival benefit in combination with chemotherapy or radiotherapy for NPC and other types of HNSCC. [12][13][14] Thus, to identify more novel molecular markers that not only can predict the prognosis individually but also provide promising therapy targets will be of great benefit for advanced NPC patients.…”

Section: Elevated Beclin 1 Expression Is Correlated With Hif-1α In Prmentioning

confidence: 99%

Elevated Beclin 1 expression is correlated with HIF-1α in predicting poor prognosis of nasopharyngeal carcinoma

Wan¹,

Fan²,

Chen³

et al. 2010

Autophagy

123

110

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“…Due to the peculiar characteristics in its epidemiology, pathology, clinical behavior and response to treatment, NPC is different from other head and neck squamous cell cancer and has a relatively high overall survival rate with the integration of chemotherapy into radiotherapy (2,3). However, the majority of NPC patients present with a late stage disease accompanying neck nodal metastases when diagnosed, and the cure rate for those advanced NPCs remains unsatisfactory (4). In addition, numerous NPC survivors are often affected by moderate to severe late complications, resulting from the impact of radiation on the organs that are adjacent to the nasopharynx and neck nodes, and chemotherapy in advanced cases further exacerbates these side-effects (5).…”

Section: Introductionmentioning

confidence: 99%

Parametric contrast-enhanced ultrasound as an early predictor of radiation-based therapeutic response for lymph node metastases of nasopharyngeal carcinoma

Huang

Zhou

et al. 2014

Molecular and Clinical Oncology

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Abstract. Nasopharyngeal carcinoma (NPC) is a common type of cancer in South East Asia with peculiar epidemiology, pathology, clinical behavior and response to treatment characteristics. To the best of our knowledge, this is the first study to investigate the use of a contrast-enhanced ultrasound (CEUS) as a predictor for the therapeutic response in lymph node metastases of NPC patients treated with radiation-based therapy. Sixty-seven NPC patients with lymph node metastases underwent the lymph nodes CEUS examination twice; pre-and in-treatment (at the 5th fraction radiotherapy), respectively. The CEUS parameters were acquired through Qontrast_4.0 software and mainly included peak intensity (PI) and time to peak (TTP). The response assessment at the lymph nodes revealed a complete response (CR) in 48 patients and partial response (PR) in 19 patients. There was a significant difference in pre-treatment PI (PI pre ) between the patients who showed CR or PR, but the predicted sensitivity and specificity of PI pre was low. The mean in-treatment PI (PI in ) value of the lymph nodes that achieved a CR was 34.24±3.78%, which was significantly higher than the PI in value for PR, 25.62±2.30% (P<0.001). Furthermore, the PI ratio , a PI-quotient, was calculated by dividing the PI in by the corresponding PI pre . The higher PI ratio was also observed in CR lymph nodes (0.81±0.01 vs. 0.66±0.01; P=0.001), and the mean change in PI (PI Δ ; PI Δ = PI pre -PI in ) was smaller in the patients with CR nodes compared to the patients with PR nodes (7.79±3.28 vs. 13.77±1.90%; P=0.000). No difference was observed in TTP pre or TTP in between the CR or PR lymph nodes patients. A receiver operating characteristic curve was constructed to assess the accuracy of the parameters for the prediction of the therapeutic responses. The sensitivity and specificity of PI in in predicting the therapeutic response was 94.3 and 88.2%, and the corresponding figures of the PI ratio were 92.5 and 83.8%, respectively. The CEUS parameters during the early course of radiation-based therapy, PI in and PI ratio , are associated with the therapeutic response of NPC lymph node metastases, with a high predicted sensitivity and specificity, thus yielding the conceivable predictors with the potential to individualize treatment.

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Multicenter, Phase II Study of Cetuximab in Combination With Carboplatin in Patients With Recurrent or Metastatic Nasopharyngeal Carcinoma

Abstract: Cetuximab in combination with carboplatin demonstrates clinical activity and an acceptable safety profile in heavily pretreated patients with recurrent or metastatic NPC who had previously experienced treatment failure with platinum-based therapy.

Cited by 267 publications

References 29 publications

Carboplatin/5-fluorouracil as an Alternative to Cisplatin/5-Fluorouracil for Metastatic and Recurrent Head and Neck Squamous Cell Carcinoma and Nasopharyngeal Carcinoma

Carboplatin/5-fluorouracil as an Alternative to Cisplatin/5-Fluorouracil for Metastatic and Recurrent Head and Neck Squamous Cell Carcinoma and Nasopharyngeal Carcinoma

Elevated Beclin 1 expression is correlated with HIF-1α in predicting poor prognosis of nasopharyngeal carcinoma

Parametric contrast-enhanced ultrasound as an early predictor of radiation-based therapeutic response for lymph node metastases of nasopharyngeal carcinoma

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