Head/Neck Cancers Symposium 2020: Addition of Cetuximab to Combination Radiotherapy Plus Cisplatin
Posted: Tuesday, March 17, 2020
A long-term update of NRG Oncology RTOG 0522, presented at the 2020 Multidisciplinary Head and Neck Cancers Symposium in Scottsdale, Arizona (Abstract 6), found that the addition of cetuximab to combination radiotherapy plus cisplatin did not result in improved survival benefits for patients with locoregionally advanced head and neck carcinoma. Jimmy J. Caudell, MD, PhD, of the Moffitt Cancer Center, Tampa, and colleagues reported that the addition of cetuximab improved none of the measurable outcomes.
A total of 891 patients were originally enrolled between November 2005 and March 2009. Participants were randomly assigned to receive radiation therapy and cisplatin with cetuximab or without cetuximab. At a median follow-up of 10.1 years, 452 patients remained alive. Cetuximab was not found to improve progression-free survival, with a rate of 43.6% without cetuximab and 40.2% with cetuximab, nor did it improve locoregional failure (28.5% vs. 34.8%) or distant metastasis (15.0% vs. 11.8%). Similarly, the overall survival rate was 49.9% without cetuximab and 50.0% with cetuximab.
When patients were stratified by p16 status, cetuximab still did not appear to provide a benefit and did not improve progression-free survival in either p16-positive oropharyngeal or non-oropharyngeal primary tumors. A correlation was noted between worsened progression-free survival and patient age older than 50 year, p16-negative oropharyngeal, non-oropharyngeal, and N2c/N3 disease.
The group that did not receive cetuximab experienced a lower grade 3 or 4 late toxicity rate (57.4% vs. 61.3%). Both groups had similar rates of grade 3 or 4 dysphagia, the most common late adverse event (39.6% vs. 38.2%). The groups were also comparable in the percentage experiencing multiple grade 3 or 4 adverse events (38.7% vs. 39.2%).
Disclosure: For full disclosures of the study authors, please visit headandnecksymposium.org.