Sarah Cannon Research Institute, Nashville, TN, USA.
Cancer J. 2011 Sep-Oct;17(5):267-72. doi: 10.1097/PPO.0b013e3182329791.
: The aim of the study was to evaluate the feasibility and efficacy of adding bevacizumab and erlotinib to concurrent chemoradiation therapy for first-line treatment of patients with locally advanced squamous carcinoma of the head and neck.
: Sixty previously untreated patients with squamous carcinoma of the head and neck (36 with oropharyngeal primaries; 83% men; median age, 56 years; 73% stage IV) received induction chemotherapy with 6 weeks of paclitaxel, carboplatin, infusional 5-fluorouracil, and bevacizumab; this treatment was followed by radiation therapy, weekly paclitaxel, bevacizumab, and erlotinib.
: After a median follow up of 32 months, the estimated 3-year progression-free and overall survival rates are 71% and 82%, respectively. Sixty-five percent of patients had major responses after induction therapy; after completion of therapy, 95% of patients had either partial or complete response radiographically. As expected, grade 3/4 mucosal toxicity occurred frequently (88%) during combined modality; no unexpected toxicity resulted from the addition of bevacizumab and erlotinib.
: The addition of bevacizumab and erlotinib to first-line combined modality therapy was feasible in a community-based setting, producing toxicity comparable to other effective combined modality regimens for head and neck cancer. The high level of efficacy suggests that incorporation of these targeted agents into first-line therapy should be further explored.
本研究旨在评估贝伐珠单抗联合厄洛替尼添加到同期放化疗一线治疗局部晚期头颈部鳞状细胞癌的可行性和疗效。
60 例未经治疗的头颈部鳞状细胞癌患者（36 例口咽癌原发灶；男性占 83%；中位年龄 56 岁；73%为 IV 期）接受了 6 周紫杉醇、卡铂、持续 5-氟尿嘧啶和贝伐珠单抗诱导化疗；随后进行放射治疗、每周紫杉醇、贝伐珠单抗和厄洛替尼治疗。
中位随访 32 个月后，估计 3 年无进展生存率和总生存率分别为 71%和 82%。诱导治疗后 65%的患者有主要反应；完成治疗后，95%的患者影像学上有部分或完全缓解。预期的联合治疗中黏膜毒性（88%）频繁发生；贝伐珠单抗和厄洛替尼的添加没有产生意外的毒性。
贝伐珠单抗和厄洛替尼联合一线综合治疗在社区环境中是可行的，产生的毒性与其他有效的头颈部癌症联合治疗方案相当。高疗效表明，应进一步探索将这些靶向药物纳入一线治疗。
