卡铂-培美曲塞治疗复发性/转移性头颈部癌；口咽原发性癌疗效更佳。

Carboplatin-pemetrexed in treatment of patients with recurrent/metastatic cancers of the head and neck; superior outcomes in oropharyngeal primaries.

作者信息

Malhotra Binu, Bellile Emily Light, Nguyen Nghia Pham Trung, Fung Vicki Kay, Slack Matthew, Bilich Rebecca, Papagerakis Silvana, Worden Francis

机构信息

Division of Hematology Oncology, Department of Medicine, University of Michigan , Ann Arbor, MI , USA.

Department of Public Health, University of Michigan , Ann Arbor, MI , USA.

出版信息

Front Oncol. 2015 Jan 26;4:362. doi: 10.3389/fonc.2014.00362. eCollection 2014.

DOI:10.3389/fonc.2014.00362

PMID:25674535

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4306299/

Abstract

BACKGROUND

Platinum-based therapy in combination with 5-fluorouracil with cetuximab has shown the best survival in pts with recurrent/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). The purpose of this study is to evaluate the efficacy and tolerability of carboplatin, pemetrexed and to assess differential outcomes in patients with oropharyngeal primary and HPV related disease.

PATIENTS AND METHODS

The charts of consecutive patients with R/M SCCHN were reviewed. All patients receiving at least one cycle of the two-drug regimen (pemetrexed 500 mg/m(2), carboplatin area under the curve of five intravenously), were included for assessment of response, safety, toxicity, and survival.

RESULTS

A total of 86 patients received this regimen between January 2008 and December 2012, of which, 63 were included in this analysis. Forty-one percent (26) of the patients had cancers of the oropharynx, and of those, 50% had HPV-positive disease, 32% (20) had cancers of the larynx, and 24% (15) of the oral cavity. Median number of cycles administered was 4 (range 1-14 cycles) with 50% of the patients receiving four or more cycles. Half the patients achieved stable disease as their best response, 8% (5) attained a partial response, 24% progressed on therapy, and the remaining patients (12) could not have their response assessed. On the basis of Kaplan-Meier analysis, median progression-free survival (PFS) was 5.1 months (95% CI 3.2, 6.2) and median overall survival (OS) was 9.4 months (95% CI 4.3, 13.1). Among pts with oropharyngeal primary (n = 26), median PFS was 6.4 months (95% CI 2.8, 7.9) and median OS was 16.6 months (95% CI 9.6, 19.5). Among HPV+ pts (n = 13), median PFS was 7.0 months (95% CI 4.8, ne) and median OS was 17.1 months (95% CI 11.2, 21.7).

CONCLUSION

Combination carboplatin-pemetrexed is an effective and well-tolerated treatment, associated with a median PFS of 5.1 months and a clinical benefit in at least 57% of the patients treated.

摘要

背景

铂类疗法联合5-氟尿嘧啶及西妥昔单抗已在复发性/转移性头颈部鳞状细胞癌（R/M SCCHN）患者中显示出最佳生存期。本研究的目的是评估卡铂、培美曲塞的疗效和耐受性，并评估口咽原发癌及HPV相关疾病患者的不同预后。

患者与方法

回顾性分析连续性R/M SCCHN患者的病历。纳入所有接受至少一个周期两药方案（培美曲塞500mg/m²，卡铂静脉滴注曲线下面积为5）治疗的患者，以评估疗效、安全性、毒性及生存期。

结果

2008年1月至2012年12月期间共有86例患者接受该方案治疗，其中63例纳入本分析。41%（26例）患者为口咽癌，其中50%为HPV阳性疾病；32%（20例）为喉癌；24%（15例）为口腔癌。中位给药周期数为4个周期（范围1 - 14个周期），50%的患者接受了4个或更多周期的治疗。半数患者最佳疗效为疾病稳定，8%（5例）达到部分缓解，24%患者治疗期间病情进展，其余患者（12例）疗效无法评估。根据Kaplan-Meier分析，中位无进展生存期（PFS）为5.1个月（95%CI 3.2, 6.2），中位总生存期（OS）为9.4个月（95%CI 4.3, 13.1）。口咽原发癌患者（n = 26）中，中位PFS为6.4个月（95%CI 2.8, 7.9），中位OS为16.6个月（95%CI 9.6, 19.5）。HPV阳性患者（n = 13）中，中位PFS为7.0个月（95%CI 4.8, ne），中位OS为17.1个月（95%CI 11.2, 21.7）。