Setüksimab ve Kemoterapi Kombinasyonu ile Tedavi Edilen Rekürren/Metastatik Baş ve Boyun Kanserli Hastalarda Tedavi Yanıtı ve Prognoz İçin Prediktif Bir Belirteç Olarak Setüksimab İlişkili Cilt Toksisitesi
Abstract
Öz
Amaç: Rekürren veya metastatik baş ve boyun kanserinde(r/mSCCHN) Setuximab (Cmab) ile ilişkili cilt toksisitesi, tedavide sık görülen bir yan etkidir. Cilt toksisitesinin prognostik bir ölçüt olarak kullanılıp kullanılamayacağını değerlendirmek istedik.
Yöntem: 2010-2019 yılları arasında Kocaeli Üniversitesi Tıbbi Onkoloji Bölümü'nde Cmab ile tedavi edilen r/mSCCHN hastalarının demografik verileri, prognostik özellikleri, tedavi yanıtları, Cmab ile ilişkili cilt toksisitesi, tanı zamanı, tedavi başlama zamanı, progresyon ve ölüm tarihleri retrospektif olarak incelenmiş ve sonuçların anlamlılığı SPSS (20.0 SPSS Inc., Chicago, IL, USA.) istatistik programı kullanılarak değerlendirilmiştir.
Bulgular: Toplam 77 hasta çalışmaya dahil edilmiştir.R/M SCCHN hastalarında Cmab ile ilişkili cilt toksisitesi ile daha uzun sağkalım arasında anlamlı bir ilişki bulunmuştur. Cilt toksisitesi olmayan hastalarda, grad 1 ve grad 2 cilt toksisitesi olanlara kıyasla daha kısa progresyonsuz sağkalım (PFS) görülmüştür. Özellikle, grad 3 cilt toksisitesi olan hastalar, cilt toksisitesi olmayanların yanı sıra grad 1 veya grad 2 toksisitesi olanlara göre daha uzun genel sağkalım (OS) ve daha iyi PFS sergilemiştir. Grad 1 veya grad 2 toksisitesi olan hastalar ile cilt toksisitesi olmayan hastalar arasında anlamlı bir OS farkı gözlenmemiştir.
Sonuç: Özellikle grad 3 cilt toksisitesi , daha uzun OS ve PFS ile yani daha iyi prognoz ile ilişkilidir. Grad 1 ve grad 2 cilt toksisitesi, cilt toksisitesi olmayanlara kıyasla daha iyi PFS ile bağlantılıdır. Bu bulgular, Cmab ile ilişkili cilt toksisitesini, özellikle de grad 2 ve grad 3 cilt toksisitesini yönetmeye yönelik önleyici stratejilerin hasta sonuçlarını iyileştirebileceğini göstermektedir.
Keywords
References
- Marur S, Forastiere AA. Head and Neck Cancer: Changing Epidemiology, Diagnosis, and Treatment. Mayo Clin Proc. 2008;83(4):489-501. doi:10.4065/83.4.489
- Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5). doi:10.1002/ijc.29210
- Clavel M, Vermorken JB, Cognetti F, et al. Randomized comparison of cisplatin, methotrexate, bleomycin and vincristine (CABO) versus cisplatin and 5-fluorouracil (CF) versus cisplatin (C) in recurrent or metastatic squamous cell carcinoma of the head and neck. A phase III study of the EORTC Head and Neck Cancer Cooperative Group. Ann Oncol. 1994;5(6):521-526. doi:10.1093/OXFORDJOURNALS.ANNONC.A058906
- Gibson MK, Li Y, Murphy B, et al. Randomized phase III evaluation of cisplatin plus fluorouracil versus cisplatin plus paclitaxel in advanced head and neck cancer (E1395): an intergroup trial of the Eastern Cooperative Oncology Group. J Clin Oncol. 2005;23(15):3562-3567. doi:10.1200/JCO.2005.01.057
- Jacobs C, Lyman G, Velez-García E, et al. A phase III randomized study comparing cisplatin and fluorouracil as single agents and in combination for advanced squamous cell carcinoma of the head and neck. J Clin Oncol. 1992;10(2):257-263. doi:10.1200/JCO.1992.10.2.257
- Forastiere AA, Metch B, Schuller DE, et al. Randomized comparison of cisplatin plus fluorouracil and carboplatin plus fluorouracil versus methotrexate in advanced squamous-cell carcinoma of the head and neck: a Southwest Oncology Group study. J Clin Oncol. 1992;10(8):1245-1251. doi:10.1200/JCO.1992.10.8.1245
- Guigay J, Aupérin A, Fayette J, et al. Cetuximab, docetaxel, and cisplatin versus platinum, fluorouracil, and cetuximab as first-line treatment in patients with recurrent or metastatic head and neck squamous-cell carcinoma (GORTEC 2014-01 TPExtreme): a multicentre, open-label, randomised, phase 2 trial. Lancet Oncol. 2021;22(4):463-475. doi:10.1016/S1470-2045(20)30755-5
- Vermorken JB, Mesia R, Rivera F, et al. Platinum-Based Chemotherapy plus Cetuximab in Head and Neck Cancer. New England Journal of Medicine. 2008;359(11):1116-1127. doi:10.1056/NEJMOA0802656/ASSET/A666E058-0210-4F26-B697-A012FB7B4135/ASSETS/IMAGES/LARGE/NEJMOA0802656_T3.JPG
- Common Terminology Criteria for Adverse Events (CTCAE) | Protocol Development | CTEP. Accessed January 6, 2025. https://ctep.cancer.gov/protocoldevelopment/electronic_applications/ctc.htm#ctc_40
- Uozumi S, Enokida T, Suzuki S, et al. Predictive Value of Cetuximab-Induced Skin Toxicity in Recurrent or Metastatic Squamous Cell Carcinoma of the Head and NECK. Front Oncol. 2018;8. doi:10.3389/fonc.2018.00616
- Pinto C, Barone CA, Girolomoni G, et al. Management of Skin Toxicity Associated with Cetuximab Treatment in Combination with Chemotherapy or Radiotherapy. Oncologist. 2011;16(2):228-238. doi:10.1634/theoncologist.2010-0298
- Salas S, Baumstarck-Barrau K, Alfonsi M, et al. Impact of the prophylactic gastrostomy for unresectable squamous cell head and neck carcinomas treated with radio-chemotherapy on quality of life: Prospective randomized trial. Radiother Oncol. 2009;93(3):503-509. doi:10.1016/J.RADONC.2009.05.016
- Lee JH, Machtay M, Unger LD, et al. Prophylactic gastrostomy tubes in patients undergoing intensive irradiation for cancer of the head and neck. Arch Otolaryngol Head Neck Surg. 1998;124(8):871-875. doi:10.1001/ARCHOTOL.124.8.871
Cetuximab-Related Skin Toxicity as a Predictive Marker for Treatment Response and Prognosis in Recurrent/Metastatic Head and Neck Cancer Patients Treated with Cetuximab and Chemotherapy Combination
Abstract
Abstract
Objective: Cetuximab (Cmab)-related skin toxicity is a frequent adverse reaction in the
treatment of recurrent or metastatic squamous cell carcinoma of the head and neck
(r/mSCCHN). We wanted to evaluate whether skin toxicity can be used as a prognostic
marker for the treatment of patients who are receiving Cmab therapy for r/mSCCHN.
Methods: A retrospective review was conducted of demographic data, prognostic features, treatment responses, Cmab-related skin toxicity, and dates of diagnosis, treatment initiation, progression, and death for r/mSCCHN patients treated with Cmab at Kocaeli University Medical Oncology Department between 2010 and 2019.Significance of the results has been evaluated by using SPSS (20.0 SPSS Inc., Chicago, IL, USA.) statistical program.
Results: A total of 77 patients were enrolled.A significant association was found between Cmab-related skin toxicity and longer survival in patients with r/mSCCHN. Patients without skin toxicity had shorter progression-free survival (PFS) compared to those with grade 1 and grade 2 skin toxicity. Notably, patients who had grade 3 skin toxicity exhibited longer overall survival (OS) and significantly better PFS than those without skin toxicity, as well as those with grade 1 or grade 2 toxicity. No significant OS difference was observed between patients with grade 1 or grade 2 toxicity and those without skin toxicity.
Conclusions: Skin toxicity, particularly grade 3, is associated with improved prognosis, with longer OS and PFS. Grade 1 and grade 2 skin toxicity are linked to better PFS compared to no toxicity. These findings suggest that preventive strategies to manage Cmab-related skin toxicity, especially grade 2 and grade 3, may enhance patient outcomes.
Keywords
Ethical Statement
Compliance with Ethical Standards: This study was approved Kocaeli University Ethics Committee (Decision number: KOU GOKAEK 2019/269)
References
- Marur S, Forastiere AA. Head and Neck Cancer: Changing Epidemiology, Diagnosis, and Treatment. Mayo Clin Proc. 2008;83(4):489-501. doi:10.4065/83.4.489
- Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5). doi:10.1002/ijc.29210
- Clavel M, Vermorken JB, Cognetti F, et al. Randomized comparison of cisplatin, methotrexate, bleomycin and vincristine (CABO) versus cisplatin and 5-fluorouracil (CF) versus cisplatin (C) in recurrent or metastatic squamous cell carcinoma of the head and neck. A phase III study of the EORTC Head and Neck Cancer Cooperative Group. Ann Oncol. 1994;5(6):521-526. doi:10.1093/OXFORDJOURNALS.ANNONC.A058906
- Gibson MK, Li Y, Murphy B, et al. Randomized phase III evaluation of cisplatin plus fluorouracil versus cisplatin plus paclitaxel in advanced head and neck cancer (E1395): an intergroup trial of the Eastern Cooperative Oncology Group. J Clin Oncol. 2005;23(15):3562-3567. doi:10.1200/JCO.2005.01.057
- Jacobs C, Lyman G, Velez-García E, et al. A phase III randomized study comparing cisplatin and fluorouracil as single agents and in combination for advanced squamous cell carcinoma of the head and neck. J Clin Oncol. 1992;10(2):257-263. doi:10.1200/JCO.1992.10.2.257
- Forastiere AA, Metch B, Schuller DE, et al. Randomized comparison of cisplatin plus fluorouracil and carboplatin plus fluorouracil versus methotrexate in advanced squamous-cell carcinoma of the head and neck: a Southwest Oncology Group study. J Clin Oncol. 1992;10(8):1245-1251. doi:10.1200/JCO.1992.10.8.1245
- Guigay J, Aupérin A, Fayette J, et al. Cetuximab, docetaxel, and cisplatin versus platinum, fluorouracil, and cetuximab as first-line treatment in patients with recurrent or metastatic head and neck squamous-cell carcinoma (GORTEC 2014-01 TPExtreme): a multicentre, open-label, randomised, phase 2 trial. Lancet Oncol. 2021;22(4):463-475. doi:10.1016/S1470-2045(20)30755-5
- Vermorken JB, Mesia R, Rivera F, et al. Platinum-Based Chemotherapy plus Cetuximab in Head and Neck Cancer. New England Journal of Medicine. 2008;359(11):1116-1127. doi:10.1056/NEJMOA0802656/ASSET/A666E058-0210-4F26-B697-A012FB7B4135/ASSETS/IMAGES/LARGE/NEJMOA0802656_T3.JPG
- Common Terminology Criteria for Adverse Events (CTCAE) | Protocol Development | CTEP. Accessed January 6, 2025. https://ctep.cancer.gov/protocoldevelopment/electronic_applications/ctc.htm#ctc_40
- Uozumi S, Enokida T, Suzuki S, et al. Predictive Value of Cetuximab-Induced Skin Toxicity in Recurrent or Metastatic Squamous Cell Carcinoma of the Head and NECK. Front Oncol. 2018;8. doi:10.3389/fonc.2018.00616
- Pinto C, Barone CA, Girolomoni G, et al. Management of Skin Toxicity Associated with Cetuximab Treatment in Combination with Chemotherapy or Radiotherapy. Oncologist. 2011;16(2):228-238. doi:10.1634/theoncologist.2010-0298
- Salas S, Baumstarck-Barrau K, Alfonsi M, et al. Impact of the prophylactic gastrostomy for unresectable squamous cell head and neck carcinomas treated with radio-chemotherapy on quality of life: Prospective randomized trial. Radiother Oncol. 2009;93(3):503-509. doi:10.1016/J.RADONC.2009.05.016
- Lee JH, Machtay M, Unger LD, et al. Prophylactic gastrostomy tubes in patients undergoing intensive irradiation for cancer of the head and neck. Arch Otolaryngol Head Neck Surg. 1998;124(8):871-875. doi:10.1001/ARCHOTOL.124.8.871
Details
| Primary Language | English |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | June 30, 2025 |
| Submission Date | February 14, 2025 |
| Acceptance Date | May 8, 2025 |
| Published in Issue | Year 2025 Volume: 8 Issue: 2 |
Cite
The articles in the Journal of "Acta Medica Nicomedia" are open access articles licensed under a Creative Commons Attribution-ShareAlike 4.0 International License at the web address https://dergipark.org.tr/tr/pub/actamednicomedia