Phase II evaluation of cetuximab (C225) combined with induction paclitaxel and carboplatin followed by C225, paclitaxel, carboplatin, and radiation for stage III/IV operable squamous cancer of the head and neck (ECOG E2303)
Carolyn Vachani, RN, MSN, AOCN
Abramson Cancer Center of the University of Pennsylvania
Last Modified: June 4, 2007
Scientific Session: Phase II evaluation of cetuximab (C225) combined with induction paclitaxel and carboplatin followed by C225, paclitaxel, carboplatin, and radiation for stage III/IV operable squamous cancer of the head and neck (ECOG E2303)
The combination of C225 and radiation has been proven superior to radiation alone for the treatment of head and neck cancer, and the addition of C225 to radiation does not appear to increase the toxicity of radiation therapy. Some patients will benefit from having chemotherapy followed by chemotherapy and radiation with C225. This phase II study added C225 to the initial chemotherapy regimen as well for stage III and IV squamous cell cancer of the head and neck.
After six weeks of chemotherapy (C225, paclitaxel and carboplatin) patients underwent a biopsy if they had a clinical response. Forty of the 65 patients underwent biopsy and 26 (65%) had no residual tumor detected. Another twenty eight patients were biopsied at week 14 per the protocol and all 28 had negative biopsies. All 54 patients who had negative biopsies at some point were sent for completion chemoradiotherapy. But, only 44% of these patients received the full course of therapy, which is quite a low number and it is uncertain why this number was so low. The researchers do not present any survival data, given the short follow up time. While this trials shows some promising numbers, there is more research to be done before this becomes a widely used regimen.