Head/Neck Cancers Symposium 2020: Concurrent Chemoradiotherapy Plus Bevacizumab
Posted: Wednesday, March 25, 2020
The use of long-term concurrent chemoradiotherapy and bevacizumab appears to be tolerable and efficacious in patients with advanced nasopharyngeal cancer. A 9-year update of the phase II RTOG 0615 trial, presented at the 2020 Multidisciplinary Head and Neck Cancers Symposium in Scottsdale, Arizona (Abstract 10), found no grade 4 hemorrhage or grade 5 adverse events occurring during follow-up, in addition to notable outcomes in survival.
“The low rate of distant metastasis despite 90% of the patients presenting with stage III to IVB disease is intriguing and warrants further investigation,” concluded Nancy Lee, MD, of Memorial Sloan Kettering Cancer Center, and colleagues.
Between December 2006 and February 2009, the study enrolled 44 evaluable patients with locally or regionally advanced nasopharyngeal cancer of at least stage IIB. At a median follow-up of 9 years, 13 deaths had occurred, with 61.5% due to disease. The late grade 3 adverse event rate was 36.4%, and the grade 3 toxicities included dysphasia (15.9%), hearing (13.6%), and xerostomia (4.5%). The 5-year progression-free survival rate was 61.2%, the 7-year rate was 56.3%, with local-regional progression-free rates of 74.9% at 5 years and 72.3% at 7 years. The 5- and 7-year distant metastasis–free survival rates did not vary between 5- and 7-year follow-ups (79.5%). The overall survival rates decreased between 5- and 7-year follow-ups (79.5% vs. 69.7%).
Participants underwent concurrent bevacizumab (15 mg/kg) and cisplatin (100 mg/m2) on days 1, 22, and 43 in addition to radiotherapy (to a total dose of 69.96 Gy over 33 fractions). Patients then received three cycles of adjuvant bevacizumab (15 mg/kg) and cisplatin (80 mg/m2) on day 1 and fluorouracil (1,000 mg/m2) on days 1 to 4.
Disclosure: For full disclosures of the study authors, visit headandnecksymposium.org.