Quality of life of patients receiving platinum-based chemotherapy plus cetuximab first line for recurrent and/or metastatic squamous cell carcinoma of the head and neck

Abstract

Background: A phase III trial demonstrated that cetuximab is the first agent in 30 years to improve survival when added to platinum-based chemotherapy (platinum-fluorouracil) first line for recurrent and/or metastatic squamous cell carcinoma of the head and neck (SCCHN). This analysis of the trial assessed the impact of treatment on quality of life (QoL).Patients and methods: The European Organisation for Research and Treatment of Cancer QoL Questionnaire-Core 30 (QLQ-C30) and QLQ-Head and Neck 35 (QLQ-H&N35) module were used to assess QoL.Results: Of 442 patients randomly assigned, 291 (QLQ-C30) and 289 (QLQ-H&N35) patients completed at least one evaluable questionnaire. For QLQ-C30, cycle 3 and month 6 mean scores for platinum–fluorouracil plus cetuximab were not significantly worse than those for platinum–fluorouracil. Pattern-mixture analysis demonstrated a significant improvement in the global health status/QoL score in the cetuximab arm (P = 0.0415) but no treatment differences in the social functioning scale. For QLQ-H&N35, the mean score for the cetuximab arm was not significantly worse than that for the chemotherapy arm for all symptom scales at all post-baseline visits. At cycle 3, some symptom scores significantly favored the cetuximab arm (pain, swallowing, speech problems, and social eating).Conclusion: Adding cetuximab to platinum–fluorouracil does not adversely affect the QoL of patients with recurrent and/or metastatic SCCHN.

Paclitaxel in combination with cetuximab exerts antitumor effect by suppressing NF-κB activity in human oral squamous cell carcinoma cell lines

“…Briefly, adding cetuximab to platinum/5-FU as first-line treatment of R/M-SCCHN significantly improved median overall survival (OS) by 2.7 months versus chemotherapy alone, without adversely impacting patients' quality of life (31,32). Based on these reports, we consider that the current first-line standard treatment approach for R/M-SCCHN must be the combination of platinum/5-FU and cetuximab.…”

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

“…Although in most cases the increased toxicity of EGFRIs was modest, it is worth noting that for some patients, including those with Asian ancestry, this toxicity can be quite severe [78]. Despite the modest increase in AE rates, clinical trial experience suggests that the addition of EGFRIs to conventional chemotherapy or CRT does not adversely affect quality of life [42,79,80]. Nevertheless, these reported observations are at odds with the experience of many medical oncologists and their patients [81], suggesting that patient-directed questionnaires used in early studies of EGFRIs may have been unable to detect subtle but meaningful effects on patients' quality of life.…”

Advanced Squamous Cell Carcinoma of the Head and Neck: The Current Role of Cetuximab

“…This was the first randomized assay that demonstrated the benefit of adding a novel drug to CT, i.e., CTX improves OS as first-line treatment in patients with recurrent/metastatic SCCHN. Later, Mesía et al [32] examined the QoL of these patients according to the EORTC criteria as well as the QLQ-C30 and QLQ-C35 questionnaires. Of the 442 randomly assigned patients, 291 completed the questionnaires.…”