nab-Paclitaxel, cisplatin, and 5-fluorouracil followed by concurrent cisplatin and radiation for head and neck squamous cell carcinoma

Douglas Adkins, Jessica Ley, Loren Michel, Tanya M. Wildes, Wade Thorstad, Hiram A. Gay, Mackenzie Daly, Jason Rich, Randal Paniello, Ravindra Uppaluri, Ryan Jackson, Kathryn Trinkaus, Brian Nussenbaum

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Objectives We previously reported the efficacy of nab-paclitaxel added to cisplatin, 5-FU, and cetuximab (APF-C) followed by concurrent high dose bolus cisplatin and radiation therapy (CRT) in patients with locally advanced head and neck squamous cell carcinoma (HNSCC). In this phase II trial, we determined the efficacy of APF (without cetuximab) followed by CRT in similar patients. Materials and methods Eligible patients had stage III–IV oropharynx (OP), larynx, or hypopharynx SCC and adequate organ function and performance status. T1 tumors were excluded. Patients were treated with three cycles of APF followed by CRT. Efficacy endpoints included two-year disease-specific survival (DSS), progression-free survival (PFS), overall survival (OS), and relapse rate. Results Thirty patients were enrolled. Most patients were smokers (77%) with bulky T3/4 (73%) and N2/3 (83%) tumors. Analyses were stratified for human papilloma virus (HPV) status: HPV-related OPSCC (n = 17; 57%) and HPV-unrelated HNSCC (n = 13; 43%). With a minimum follow-up of 21 months, relapse occurred in 1 (3%) patient. Two-year DSS was 94% in HPV-related OPSCC and 100% in HPV-unrelated HNSCC. Two-year PFS was 94% in HPV-related OPSCC and 100% in HPV-unrelated HNSCC. Two-year OS was 94% in HPV-related OPSCC and 92% in HPV-unrelated HNSCC. Causes of death were relapse (1), treatment-related mortality (1), and co-morbidity (1). Two patients with HPV-unrelated HNSCC treated with APF declined CRT and remained free of relapse at 36 and 28 months of follow-up. Conclusion This phase II trial demonstrated favorable two-year DSS, PFS, and OS and a low relapse rate in HPV-unrelated HNSCC and HPV-related OPSCC treated with APF followed by CRT.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalOral Oncology
Volume61
DOIs
StatePublished - Oct 1 2016

Keywords

  • 5-Fluorouracil
  • Chemotherapy
  • Cisplatin
  • Head and neck cancer
  • Induction
  • nab-Paclitaxel

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