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Cetuximab, Paclitaxel, Carboplatin, and Radiation for Head and Neck Cancer: A Survival Analysis of a Brown University Oncology Group Phase II Study

Birnbaum, Ariel MD; Dipetrillo, Thomas MD; Rathore, Ritesh MD; Merriam, Priscilla MD; Wanebo, Harry MD; Thomas, Anthony MD; Puthawala, Yacoub MD; Joyce, Donald MD; Luppe, Denise RN; Khurshid, Humera MD; Follett, Nancy RN; Sio, Terence Tai-Weng MD; Safran, Howard MD

American Journal of Clinical Oncology: April 2014 - Volume 37 - Issue 2 - p 162–166
doi: 10.1097/COC.0b013e31826e06e0
Original Articles: Head & Neck

Objectives: To assess the effect on progression-free and overall survival from the addition of cetuximab to paclitaxel-based chemoradiation for patients with squamous cell head and neck cancer from Brown University Oncology Group studies.

Methods: BrUOG HN-204 patients with stage III or IV locally advanced squamous cell cancer of the head and neck without distant organ metastases received 4 weeks of induction cetuximab followed by weekly cetuximab, paclitaxel, carboplatin, and concurrent radiation. Recurrence and survival data were compared with previous Brown University studies utilizing the same paclitaxel-based chemoradiation with and without induction chemotherapy.

Results: The progression-free survival and overall survival at 3 years for all 37 patients initiating chemoradiation was 54% and 57%, respectively. All surviving patients were followed for at least 3 years and the median follow-up is 4.4 years. Of 14 patients who recurred within 3 years, 7 patients recurred locally only, 5 had a systemic recurrence, and 2 recurred both locally and systemically.

Conclusions: The addition of cetuximab to paclitaxel, carboplatin, and radiation achieves overall survival that is virtually identical to prior Brown University Oncology Group studies of paclitaxel-based chemoradiation without cetuximab. Improvements in locoregional control are needed despite the use of 3 agents to enhance the effects of radiation.

Brown University Oncology Group, Providence, RI

Supported by Bristol-Myers Squibb.

The authors declare no conflicts of interest.

Reprints: Howard Safran MD, Brown University Oncology Group, 97 Waterman Street, P.O. Box G-A 418, Providence, RI 02912. E-mail: hsafran@lifespan.org)

© 2014 by Lippincott Williams & Wilkins, Inc