Vermorken Jan B, Herbst Roy S, Leon Xavier, Amellal Nadia, Baselga Jose
Department of Medical Oncology, University Hospital Antwerp, Edegem, Belgium.
Cancer. 2008 Jun 15;112(12):2710-9. doi: 10.1002/cncr.23442.
The epidermal growth factor receptor (EGFR) inhibitor cetuximab is active in recurrent and/or metastatic squamous cell carcinoma of the head and neck (SCCHN). The activity of cetuximab was compared with that of commonly used treatments in this setting.
All patients had recurrent and/or metastatic SCCHN and had progressed on cisplatin- or carboplatin-based chemotherapy. Efficacy data from 3 prospective studies (n=278 patients) that administered cetuximab as a single agent (n=103 patients) or combined with either cisplatin/carboplatin (n=96 patients) or cisplatin (n=79 patients) were compared with the results from a retrospective study of patients who received various second-line treatments (all treatments including best supportive care only, n=151 patients; chemotherapy, n=43 patients). Safety data considered were only those from the cetuximab studies.
Over the 3 cetuximab trials, overall response rates from 10% to 13% and disease control rates from 46% to 56% were observed. The median time to disease progression ranged between 2.2 months and 2.8 months, and the median overall survival ranged between 5.2 months and 6.1 months. No patients who progressed on cetuximab alone responded to additional platinum. These survival data compared favorably with those from the retrospective study (median survival, 3.4 months [n=151 patients] and 3.6 months [n=43 patients]). Cetuximab-based treatments generally were tolerated well, and cetuximab did not increase the side effects associated with platinum therapy.
Cetuximab has the potential to prolong survival in patients with recurrent and/or metastatic SCCHN who fail on platinum therapy compared with various second-line therapies. Cetuximab did not increase the toxicities associated with chemotherapy. The results obtained by treatment with cetuximab alone after platinum failure did not appear to differ from the results obtained by reintroducing platinum in combination with cetuximab.
表皮生长因子受体（EGFR）抑制剂西妥昔单抗对头颈部复发性和/或转移性鳞状细胞癌（SCCHN）具有活性。在此背景下，将西妥昔单抗的活性与常用治疗方法的活性进行了比较。
所有患者均患有复发性和/或转移性SCCHN，且基于顺铂或卡铂的化疗已进展。将3项前瞻性研究（n = 278例患者）的疗效数据进行比较，这3项研究中，西妥昔单抗作为单药使用（n = 103例患者），或与顺铂/卡铂联合使用（n = 96例患者），或与顺铂联合使用（n = 79例患者），并与一项对接受各种二线治疗的患者进行的回顾性研究结果进行比较（所有治疗包括仅最佳支持治疗，n = 151例患者；化疗，n = 43例患者）。所考虑的安全性数据仅来自西妥昔单抗研究。
在3项西妥昔单抗试验中，观察到总体缓解率为10%至13%，疾病控制率为46%至56%。疾病进展的中位时间在2.2个月至2.8个月之间，总体生存的中位时间在5.2个月至6.1个月之间。仅接受西妥昔单抗治疗后病情进展的患者对额外的铂类药物均无反应。这些生存数据与回顾性研究的数据相比更具优势（中位生存期，3.4个月[n = 151例患者]和3.6个月[n = 43例患者]）。基于西妥昔单抗的治疗一般耐受性良好，且西妥昔单抗未增加与铂类治疗相关的副作用。
与各种二线治疗相比，西妥昔单抗有可能延长铂类治疗失败的复发性和/或转移性SCCHN患者的生存期。西妥昔单抗未增加与化疗相关的毒性。铂类治疗失败后单独使用西妥昔单抗获得的结果似乎与重新引入铂类联合西妥昔单抗获得的结果没有差异。
