Retrospective analysis of chronomodulated chemotherapy versus conventional chemotherapy with paclitaxel, carboplatin, and 5-fluorouracil in patients with recurrent and/or metastatic head and neck squamous cell carcinoma

Abstract

BackgroundChronomodulated chemotherapy has emerged as a new therapy as a result of recent studies focusing on the biological clock. It has been demonstrated that combination chronomodulated chemotherapy of platinum-based drugs and 5-fluorouracil (5-Fu) can significantly improve efficacy and reduce the incidence of adverse events in patients with metastatic colorectal cancer, as compared with conventional chemotherapy. However, the results may be different in different tumors. Recurrent and metastatic head and neck squamous cell carcinoma (HNSCC) is very difficult to treat, with an extremely unfavorable prognosis. So far, no report is available on chronomodulated chemotherapy for HNSCC.MethodsRetrospective analyses were made on 49 patients with local recurrent and/or metastatic HNSCC who underwent palliative treatments with paclitaxel, carboplatin, and 5-Fu. The patients were divided into a chronomodulated chemotherapy group (28 patients) and a conventional chemotherapy group (21 patients) according to their administration times. The two groups were compared for tumor objective response rate, overall survival (OS), progression-free survival (PFS), and the incidence of adverse events.ResultsThe tumor objective response rate and patients’ OS were significantly higher and longer in the chronomodulated chemotherapy group than in the conventional chemotherapy group (71.43% versus 42.86%, respectively, P<0.05; and median OS 15.3 months versus 10.6 months, respectively, P<0.05). However, PFS was similar statistically (median PFS 11.6 months versus 7.2 months, P>0.05). The global incidence of adverse events in the chronomodulated chemotherapy group was significantly lower than that in the conventional chemotherapy group (46.43% versus 76.19%, P<0.05), with significantly lower incidence of grade 3–4 adverse events (7.14% versus 33.33%, P<0.05).ConclusionChronomodulated chemotherapy with paclitaxel, carboplatin, and 5-Fu may be a new and effective therapy for patients with recurrent and/or metastatic HNSCC as compared with conventional chemotherapy.

Fatty acid synthase as a potential therapeutic target in feline oral squamous cell carcinoma

“…Previous work has associated increased FASN expression with chemotherapy resistance and demonstrated a chemosensitizing effect of orlistat‐mediated FASN inhibition in human malignancies . We hypothesized that orlistat treatment would increase susceptibility of OSCC cells to treatment with carboplatin, a platinum‐based chemotherapy drug used frequently in oral cancer treatment in both feline and human patients . This hypothesis was not supported by our results; rather, an antagonistic effect of dual treatment was detected in all cell lines.…”

Research progress on circadian clock genes in common abdominal malignant tumors (Review)

“…The new interdiscipline generated by the integration of chronobiology and onco-molecular biology is expected to expand the knowledge about tumor occurrence and development, and may provide a new approach for tumor therapy ( 98 – 102 ). Tumor chronotherapy, which is the selection of the optimum treatment time to achieve the maximum curative effect and the minimum toxic and side effects based on the rhythm characteristics of tumor growth, has achieved satisfactory results in clinical practice ( 98 – 102 ). However, the association between clock genes and tumors remains to be fully understood.…”

Opening the Debate: How to Fulfill the Need for Physicians’ Training in Circadian-Related Topics in a Full Medical School Curriculum

“…Findings revealed that current cisplatin-based chronotherapy protocols show advantages in relieving side effects of chemotherapy in patients by directly influencing the chemo drug’s metabolism [ 37 ]. Similarly, chronomodulated chemotherapy of platinum-based drugs and 5-fluorouracil can significantly improve efficacy and reduce adverse events in patients with metastatic colorectal cancer; however, these results must be taken with caution as its effect may be different for the treatment of other solid tumors [ 38 ]. Nevertheless, what started as a growing understanding of the importance of biological timing for normal physiology and the pathophysiology of diseases like cancer is now a more comprehensive field that revolves around cancer-associated clock disruptions, clock-dependent mechanisms of cancer, and chronotherapeutic approaches.…”