Palliative chemotherapy with or without cetuximab in recurrent or metastatic squamous cell carcinoma of the head and neck: Indian tertiary care retrospective analysis

Abstract

Background: We report our experience with Indian patients who received palliative chemotherapy with/without cetuximab for recurrent/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). Methods: Data from 229 R/M SCCHN patients treated with cetuximab and chemotherapy (n = 140) or chemotherapy alone (n = 89) were retrospectively analyzed for response rate (RR), progression-free survival (PFS), overall survival (OS), and safety.Results: Patients receiving cetuximab with chemotherapy demonstrated significant increase in RR (77.1% vs 44.9%, P = .0001), PFS (8.1 vs 6.1 months, P = .039), and OS (11.8 vs 8.0 months, P = .002) compared with patients receiving chemotherapy alone. Continuing cetuximab and changing chemotherapy combination (second line and beyond) in fit patients doubled OS (13.5 vs 6.1 months, P = .001). Adverse effects, except skin reactions (more in the cetuximab with chemotherapy group; P = .001), were similar in both groups.Conclusion: Adding cetuximab to chemotherapy improved ORR, PFS, and OS in Indian R/M SCCHN patients, and cetuximab was well tolerated.cetuximab, head and neck cancer, metastatic disease, palliative, recurrent disease Meetings at which the manuscript was

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

“… 43 , 44 Among Anti‐EGFR Mabs, cetuximab (a highly studied Mab in SCC treatment) such as zalutumumab and panitumumab has shown favorable outcomes in locoregionally advanced, recurrent, or metastatic HNSCC, specifically HPV‐negative SCCs. 49 , 50 , 53 , 55 , 56 , 57 , 58 , 60 , 171 , 172 , 173 Cetuximab is also helpful in sensitizing the tumor to radiotherapy. 45 , 46 , 47 Cetuximab showed some grade 3 and 4 adverse effects such as folliculitis, anemia, trichomegaly, 48 acneiform rash and infusion, 45 neutropenia, 50 and hyper transaminasemia 174 with different doses of chemo‐ and radiotherapy.…”

“…The most potent Mabs in HNSCC are EGFR antagonists and checkpoint inhibitors, especially PD‐L1 antagonists. 49 , 50 , 53 , 55 , 56 , 57 , 58 , 60 , 116 , 117 , 128 , 130 , 131 , 142 , 143 , 148 , 165 , 171 , 172 , 173 Mabs have also been approved by FDA for treating HNSCC, including cetuximab and pembrolizumab. Cetuximab was approved as monotherapy or in combination with chemotherapy in locally or regionally advanced and recurrent or metastatic HNSCC after treatment with platinum‐based therapy.…”

“…Most HNSCCs express high levels of EGFR 43,44 . Among Anti‐EGFR Mabs, cetuximab (a highly studied Mab in SCC treatment) such as zalutumumab and panitumumab has shown favorable outcomes in locoregionally advanced, recurrent, or metastatic HNSCC, specifically HPV‐negative SCCs 49,50,53,55–58,60,171–173 . Cetuximab is also helpful in sensitizing the tumor to radiotherapy 45–47 .…”

Photodynamic therapy combined with simple surgery is effective as the palliative care for a patient with multiple squamous cell carcinomas

“…Palliative treatments for SCCs are limited, platinum‐based regimen with 5‐fluorouracil (5‐FU) or a taxane may be the main protocol 6 . However, there are side effects of radiotherapy or chemotherapy, which will lead to increased postoperative discomfort and poor efficacy.…”

“…Palliative treatments for SCCs are limited, platinum-based regimen with 5-fluorouracil (5-FU) or a taxane may be the main protocol. 6 However, there are side effects of radiotherapy or chemotherapy, which will lead to increased postoperative discomfort and poor efficacy. In our case report, the patient refused to take radiotherapy, chemotherapy, nor immunosuppressive agents, so PDT combination therapy is well worth recommending.…”