Combination Pazopanib Plus Cetuximab Therapy Warrants Further Study
Posted: Thursday, August 2, 2018
Patients with head and neck squamous cell carcinoma may benefit from escalating pazopanib doses in addition to cetuximab treatment, according to a recent study published in The Lancet Oncology. The phase Ib trial, conducted by Douglas Adkins, MD, of the Washington University School of Medicine, St. Louis, sought to determine the maximum tolerated dose of pazopanib when given in conjunction with standard cetuximab therapy.
Dr. Adkins and colleagues concluded, “Encouraging preliminary antitumour activity was observed with this combination therapy and [it] warrants further validation in randomised trials.” The authors also concluded that their study findings might be useful in developing future studies of combinations of angiogenetic and PD-1 inhibitors in this patient population.
The primary segment of the study, performed between 2013 and 2017, included 22 patients with recurrent or metastatic head and neck squamous cell carcinoma. Participants received a weekly intravenous treatment of cetuximab (400 mg/m2 first dose and 250 mg/m2 thereafter) in combination with an increasing daily dose (200, 400, 600, or 800 mg/day) of oral suspension pazopanib in 8-week cycles. As an extension of this trial, an additional nine patients with head and neck squamous cell carcinoma were treated with the recommended maximum treatment of weekly intravenous cetuximab identical to the primary group with an additional daily pazopanib treatment at 800 mg/day in 8-week cycles.
The researchers did not identify a maximum tolerated dosage of pazopanib plus cetuximab in this study. Overall, 2 of the 31 participants were assessed as having had a complete response to this treatment, with an additional 9 patients achieving a partial response. The most frequent adverse reactions observed included hypertension ( n = 10), lymphocyte count decrease (n = 7), and dysphagia (n = 7).