Place in Concomitant Use with AntiEGFR Radiotherapy in Locally Advanced Head and Neck Cancer Treatment
Öz
Head and neck cancer (HNC) forms 8% of the adult cancers and each year approximately 600.000 new cases occur. In the course of application, about 40% of the cases are in early stage, 50% is locally advanced (stage III and IV) and 10% is in metastatic stage. More than 90% of the cases are squamous cell carcinoma and alcohol and smoking are common etiological factors. Human papillomavirus virus is a risk factor especially for oropharyngeal squamous cell carcinoma (1). The anatomic localization of the disease, the stage of the disease, pathological features and the other diseases of the patient (comorbidity) are important factors to choose the treatment. Although there is not only one approach of treatment, surgical cure and radiotherapy have the similar survival results in early stage. For locally advanced cases, radiotherapy or concomitant chemoradiotherapy is widely used. In concomitant chemoradiotherapy implementations, cisplatin is the gold standard treatment. However, the toxicity related with chemotherapy (particularly cisplatin) restricts the application of chemoradiotherapy with especially the patients who have comorbidity. Epidermal growth factor receptor (EGFR) shows abnormal activity in several epithelial cancers including HNC. Therefore, there are so many done and ongoing studies, which are about different kinds of cancers with the agents who target this pathway (2). Firstly, in the study of Bonner et al. (3) only radiotherapy (RT) and cetuximab treatments with RT are compared. In combination arm in comparison with only RT, a significantly better local-regional control is statistically provided (median 14.9 months against 24.4 months and p=0.005). Accordingly, while median survival is 49 months in cetuximab and RT arm for overall survival (OS), it has been found more superior in combination arm as 29.3 months (p=0.03) in RT arm.
Anahtar Kelimeler
Epidermal growth factor receptor inhibitors radiotherapy chemoterapy
Kaynakça
- 1. GLOBOCAN: Estimated Cancer Incıdence and Mortality and Prevalence Worldwide in 2012. Available from: [http://globocan.iarc.fr](http://globocan.iarc.fr)
- 2. Seiwert TY, Salama JK, Vokes EE. The chemodadition paradigm in head and neck cancer. Nat Clin Pract Oncol 2007; 4: 156-71.
- 3. Bonner JA, Harari PM, Grialt J, Azarnia N, Shin DM, Cohen RB, Jones CU, et al. Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Eng J Med 2006; 354: 567-78.
- 4. Vermoken JB, Mesia R, Rivera F, Remenar E, Kawecki A, Rottey S, et al. Platinum-based chemotherapy plus cetuximab in head and neck cancer. N Engl J Med 2008; 359: 1116-27.
- 5. Ang KK, Zhang Q, Rosenthal DI, Nguyen-Tan PF, Sherman EJ, Weber RS, et al. Randomized phase III trial of concurebt accelerated radiation plus cisplatin with or without cetuximab for stage III to IV head and neck carcinoma: RTOG 0522. J Clin Oncol 2014; 32: 2940-50.
- 6. Mesia R, Henke M, Fortin A, Minn H, Yunes Ancona AC, Cmelak A, et al. Chemoradiotherapy with or without panitumumab in patients with unresected, locally advanced squamous-cell carcinoma of the head and neck (CONCERT-1): a randomised, controlled, open-label, phase 2 trial. Lancet Oncol 2015; 16: 208-20.
- 7. Grialt J, Trigo J, Nuyts S, Ozsahin M, Skladowski K, Hatoum G, et al. Panitumumab plus radiotherapy versus chemoradiotherapy in patients with unresected, locally advanced squamous-cell carcinoma of the head and neck (CONCERT-2): a randomised, controlled, open-label phase 2 trial. Lancet Oncol 2015; 16: 221-32.
- 8. Martin RG, Parvathaneni U, Bauman JE, Sharma AK, Raez LE, Papagikos MA, et al. Cisplatin and radiotherapy with or without erlotinib in locally advanced squamous cell carcinoma of the head and neck: a randomized phase 2 trial. J Clin Oncol 2013; 31: 1415-21.
- 9. Rodriguez CP, Adelstein DJ, Rybicki LA, Saxton JP, Lorenz RR, Wood BG, et al. Single-arm phase 2 study of multiagent concurent chemotherapy and gefitinib in locoregionally advanced squamous cell carcinoma of the head and neck. Wiley Online Library 2011; 34: 1517-23.
- 10. Gregoire V, Hamoir M, Chen C, Kane M, Kawecki A, Julka PK, et al. Gefitinib plus cisplatin and radiotherapy in previously untreated head and neck squamous cell carcinoma: a phase 2, randomized, double-blind, placebo-controlled study. Radiother Oncol 2011; 100: 62-9.
- 11. Burtness B, Bourhis JP, Vermorken JB, Harrington KJ, Cohen EE. Afatinin versus placebo as adjuvant therapy after chemoradiation in double-blind, phase 3 study (LUX-Head\&Neck 2) in patients with primary unresected, clinically intermediate-to-high risk head and neck cancer: study protocol for a randomized controlled trial. Trials 2014; 15: 469.
Öz
Kaynakça
- 1. GLOBOCAN: Estimated Cancer Incıdence and Mortality and Prevalence Worldwide in 2012. Available from: [http://globocan.iarc.fr](http://globocan.iarc.fr)
- 2. Seiwert TY, Salama JK, Vokes EE. The chemodadition paradigm in head and neck cancer. Nat Clin Pract Oncol 2007; 4: 156-71.
- 3. Bonner JA, Harari PM, Grialt J, Azarnia N, Shin DM, Cohen RB, Jones CU, et al. Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Eng J Med 2006; 354: 567-78.
- 4. Vermoken JB, Mesia R, Rivera F, Remenar E, Kawecki A, Rottey S, et al. Platinum-based chemotherapy plus cetuximab in head and neck cancer. N Engl J Med 2008; 359: 1116-27.
- 5. Ang KK, Zhang Q, Rosenthal DI, Nguyen-Tan PF, Sherman EJ, Weber RS, et al. Randomized phase III trial of concurebt accelerated radiation plus cisplatin with or without cetuximab for stage III to IV head and neck carcinoma: RTOG 0522. J Clin Oncol 2014; 32: 2940-50.
- 6. Mesia R, Henke M, Fortin A, Minn H, Yunes Ancona AC, Cmelak A, et al. Chemoradiotherapy with or without panitumumab in patients with unresected, locally advanced squamous-cell carcinoma of the head and neck (CONCERT-1): a randomised, controlled, open-label, phase 2 trial. Lancet Oncol 2015; 16: 208-20.
- 7. Grialt J, Trigo J, Nuyts S, Ozsahin M, Skladowski K, Hatoum G, et al. Panitumumab plus radiotherapy versus chemoradiotherapy in patients with unresected, locally advanced squamous-cell carcinoma of the head and neck (CONCERT-2): a randomised, controlled, open-label phase 2 trial. Lancet Oncol 2015; 16: 221-32.
- 8. Martin RG, Parvathaneni U, Bauman JE, Sharma AK, Raez LE, Papagikos MA, et al. Cisplatin and radiotherapy with or without erlotinib in locally advanced squamous cell carcinoma of the head and neck: a randomized phase 2 trial. J Clin Oncol 2013; 31: 1415-21.
- 9. Rodriguez CP, Adelstein DJ, Rybicki LA, Saxton JP, Lorenz RR, Wood BG, et al. Single-arm phase 2 study of multiagent concurent chemotherapy and gefitinib in locoregionally advanced squamous cell carcinoma of the head and neck. Wiley Online Library 2011; 34: 1517-23.
- 10. Gregoire V, Hamoir M, Chen C, Kane M, Kawecki A, Julka PK, et al. Gefitinib plus cisplatin and radiotherapy in previously untreated head and neck squamous cell carcinoma: a phase 2, randomized, double-blind, placebo-controlled study. Radiother Oncol 2011; 100: 62-9.
- 11. Burtness B, Bourhis JP, Vermorken JB, Harrington KJ, Cohen EE. Afatinin versus placebo as adjuvant therapy after chemoradiation in double-blind, phase 3 study (LUX-Head\&Neck 2) in patients with primary unresected, clinically intermediate-to-high risk head and neck cancer: study protocol for a randomized controlled trial. Trials 2014; 15: 469.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Radyoterapi |
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Nisan 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 19 Sayı: 1 |