Carboplatin in combination with weekly Paclitaxel as first-line therapy in patients with recurrent/metastatic head and neck squamous cell carcinoma unfit to EXTREME schedule
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Adeline Pêtre1, Cécile Dalban1, Andy Karabajakian1, Eve-Marie Neidhardt1, Pierre Eric Roux1, Marc Poupart1, Sophie Deneuve1, Philippe Zrounba1 and Jérome Fayette1
1Centre de Lutte Contre le Cancer Léon Bérard, Lyon-I University, Lyon, France
Jérome Fayette, email: [email protected]
Keywords: head and neck cancer; recurrence; metastasis; first-line; unfit
Received: January 11, 2018 Accepted: March 28, 2018 Published: April 24, 2018
The standard first-line treatment in recurrent/metastatic head and neck squamous cell carcinoma combines Cisplatin, 5 Fluorouracil and Cetuximab, but many patients aren’t eligible. We retrospectively evaluated the efficacy and the tolerability of Carboplatin and Paclitaxel in this indication, mostly in patients unfit to Cisplatin.
Paclitaxel (80mg/m2) was administered at day 1, 8 and 15 and Carboplatin area under the curve 5 at day 1, repeated every 28 days, for 6 cycles. Carboplatin could be administered at area under the curve 2 at day 1, 8 and 15.
117 patients received this association at our institution, 94 of those were ineligible to cisplatin due to severe comorbidities, age >70years or Performance status >1.
The overall response rate was 40%. The median progression free survival for patients ineligible to Cisplatin was 4.4 months [95% CI; 3.4; 5.0] and the median overall survival was 8 months [95% CI; 5.4–10.7].
The most frequent toxicities were hematologic, with 94 grade ≥ 3, mostly in patients who received monthly Carboplatin.
Our study shows Carboplatin and Paclitaxel in first-line in recurrent/metastatic head and neck squamous cell carcinoma appear efficient for patients ineligible to Cisplatin and safe when both drugs are weekly administered.
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