Phase II study of bevacizumab in combination with docetaxel and radiation in locally advanced squamous cell carcinoma of the head and neck

Abstract

Purposes To establish the efficacy and toxicities of concurrent bevacizumab and docetaxel with radiation for locally advanced HNSCC. Materials/Methods Patients with previously untreated HNSCC received standard daily radiotherapy with concurrent weekly docetaxel (20 mg/m2) and biweekly bevacizumab (5 mg/kg). Biweekly bevacizumab was then continued for up to one year following radiotherapy. The primary objective was progression-free survival (PFS). Secondary objectives included overall survival, patterns of failure, and toxicities of treatment. Results Thirty patients were recruited. With median follow-up of 38 months, the 3 year PFS, OS, locoregional recurrence free survival and distant metastasis free survival was 61.7%, 68.2%, 84.5%, and 80.5%, respectively. The most common local toxicities were mucositis and dermatitis. Two patients developed hemorrhage. There was no grade 5 toxicity. Conclusions The combination of bevacizumab, docetaxel and radiotherapy is tolerable and effective in HNSCC. This regimen is worthy of further study in appropriate subset of patients receiving chemoradiation therapy.

Angiogenesis in Head and Neck Cancer

“…Yao et al reported safety and efficacy of combination of bevacizumab, docetaxel and radiotherapy; due to promising results (3 year PFS, OS, locoregional recurrence free survival and distant metastasis free survival was 61.7%, 68.2%, 84.5%, and 80.5%, respectively) this study on 30 pts is worthy of further study in appropriate subset of patients receiving chemoradiation therapy [29]. Definitive results of further studies of Bevacizumab with chemotherapy, chemoradiation and/or with target therapies (cetuximab or erlotinib) are still pending.…”

Phase II study of erlotinib and docetaxel with concurrent intensity‐modulated radiotherapy in locally advanced head and neck squamous cell carcinoma

“…In our study, docetaxel administered at a weekly dose of 20 mg/m 2 during concurrent radiation treatment was well‐tolerated. Our group has also completed a phase II study combining radiation, docetaxel, and bevacizumab and has demonstrated that docetaxel at 20 mg/m 2 /week was well‐tolerated in combination with bevacizumab and radiation . It is of interest to note that a lower docetaxel dose (15 mg/m 2 /week) was selected in the phase III RTOG 1216 clinical trial…”

Immunotherapy for Head and Neck Squamous Cell Carcinoma

“…This shows promise to improve immunotherapy results with Cetuximab 57 , and will need further study. Bevacizumab has also been combined with docetaxel and radiation with an overall survival of 68% and 3 year recurrence free survival of 80.5% 58 .…”