Does Following Induction Therapy With Cetuximab Radiotherapy Improve Outcomes in Head and Neck Cancers?
Posted: Thursday, October 4, 2018
A study published in the Journal of Clinical Oncology concluded that induction chemotherapy plus cetuximab radiotherapy does not improve outcomes versus concurrent chemoradiotherapy for patients with head and neck cancers. Lionnel Geoffrois, MD, of the Institut de Cancérologie de Lorraine in France, and colleagues also noted that the rates of severe neutropenia and febrile neutropenia were higher with induction plus cetuximab radiotherapy.
Between 2009 and 2013, 370 patients with nonmetastatic N2b, N2c, or N3 squamous cell carcinoma were included in the study. Participants were randomized to receive either docetaxel, cisplatin, and fluorouracil (TPF) induction therapy followed by cetuximab and radiation (n = 181) or the standard of care, concurrent chemotherapy of carboplatin and fluorouracil (n = 179).
At a median follow-up of 2.8 years, progression-free survival was “not different” between the study arms: 36% in the TPF induction therapy arm and 38% in the concurrent chemotherapy arm (P = .58). Researchers noted no significant differences in overall survival between the groups.
Participants undergoing TPF induction therapy followed by cetuximab and radiation reported more frequent occurrences of grade 3 and 4 fever (9% vs. 0.6%), grade 3 and 4 neutropenia (26% vs. 6%), febrile neutropenia (17% vs. 0%), and grade 3 and 4 skin reactions within the radiation fields (53% vs. 29%) than did patients treated with the standard of care. A total of 6.6% of patients included in the TPF induction therapy arm experienced treatment-related death versus 0.6% in the concurrent chemotherapy group.