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CC BY-NC-ND 4.0 · South Asian J Cancer 2017; 06(01): 011-014
DOI: 10.4103/2278-330X.202558
ORIGINAL ARTICLE: Head and Neck Cancer

A tertiary care experience with paclitaxel and cetuximab as palliative chemotherapy in platinum sensitive and nonsensitive in head and neck cancers

Vanita Noronha
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Vijay M. Patil
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Amit Joshi
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Atanu Bhattacharjee
Division of Clinical Research and Biostatistics, Malabar Cancer Centre, Kannur, Kerala
,
Davinder Paul
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Sachin Dhumal
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Shashikant Juvekar
Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra
,
Supreeta Arya
Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra
,
Kumar Prabhash
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
› Author Affiliations Financial support and sponsorship: Nil.
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Abstract

Bacground: The combination of paclitaxel and cetuximab (PaCe) has led to an encouraging response rate in Phase 2 setting with limited toxicity. The aim of our study was to assess the efficacy of this regimen in our setting in platinum sensitive and nonsensitive patients. Methods: This was a retrospective analysis of head and neck cancer patients treated with weekly PaCe as palliative chemotherapy between May 2010 and August 2014. The standard schedule of cetuximab along with 80 mg/m2 of weekly paclitaxel was administered till either disease progression or withdrawal of patient's consent. The toxicity and response were noted in accordance with CTCAE version 4.02 and RECIST version 1.1 criteria, respectively. The response rates between platinum sensitive and nonsensitive patients were compared by Chi-square test. Overall survival (OS) and progression-free survival (PFS) were estimated by Kaplan–Meier survival method and log-rank test was used for comparison. Cox proportional hazard model was used for identification of factors affecting PFS and OS. Results: One Hundred patients with a median age of 52 years (interquartile range: 46–56 years) were included. Forty-five patients (45%) were platinum insensitive, whereas 55 patients (55%) were platinum sensitive. In platinum insensitive patients and sensitive patients, the response rates were 38.5% and 22.2%, respectively (P = 0.104), whereas the symptomatic benefit in pain was seen in 89.5% and 71.7%, respectively (P = 0.044). The median PFS in platinum insensitive and sensitive patients were 150 and 152 days, respectively (P = 0.932), whereas the median OS was 256 days (95% confidence interval [95% CI]: 168.2–343.8 days) and 314 days (95% CI: 227.6–400.4 days), respectively (P = 0.23). Nineteen patients (19%) had grades 3–4 adverse events during chemotherapy. Conclusion: Weekly paclitaxel combined with cetuximab has promising efficacy and good tolerability in the palliative setting in advanced head and neck cancer in both platinum sensitive and insensitive patients.

Key words

Head and neck cancer - metastatic - oral cancer - palliative chemotherapy - recurrent - weekly paclitaxel


Publication History

Article published online:
22 December 2020

© 2017. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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