每周紫杉醇和西妥昔单抗与 EXTREME 方案治疗复发性/转移性鳞状细胞头颈部癌的比较。

A comparison of weekly paclitaxel and cetuximab with the EXTREME regimen in the treatment of recurrent/metastatic squamous cell head and neck carcinoma.

机构信息

Departments of Medical Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.

Departments of Pathology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.

出版信息

Oral Oncol. 2017 Oct;73:21-26. doi: 10.1016/j.oraloncology.2017.07.022. Epub 2017 Aug 5.

DOI:10.1016/j.oraloncology.2017.07.022

PMID:28939072

Abstract

BACKGROUND

The effectiveness of the combination chemotherapy of weekly paclitaxel and cetuximab has not yet been compared to that of the current standard regimen, EXTREME (combination of 5-fluorouracil, cisplatin and cetuximab).

METHODS

We retrospectively reviewed the clinical records of R/M SCCHN patients who received cetuximab-containing chemotherapy as a first-line therapy; from these, patients receiving a weekly paclitaxel and cetuximab regimen (cohort A) and the EXTREME regimen (cohort B) were extracted. The responses, prognoses and adverse events of these two cohorts were evaluated.

RESULTS

A total of 86 patients were included (cohort A, 49; cohort B, 36). Patients with histories of platinum-based chemotherapy were more frequently given the cohort A treatment. Though the response rates were similar in the two cohorts (45% in cohort A and 51% in cohort B; p=0.83), the progression-free survival (PFS) was significantly more favorable in cohort A by the log-rank test (6.0monthsvs 5.0months; p=0.027). In the Cox-regression hazard analyses, male gender (hazard ratio [HR]=2.1, p=0.010), older age (≥ 70 yo) (HR=5.0, p=0.018), PS 0 (HR=2.2, p=0.027), no history of platinum chemotherapy (HR=3.2, p=0.003) and the presence of a tracheostomy (HR=2.3, p=0.039) were favorable factors within cohort A.

CONCLUSION

In selected R/M SCCHN patients, the combination of weekly paclitaxel and cetuximab could be the better treatment option than the EXTREME regimen.

摘要

背景

每周紫杉醇联合西妥昔单抗的化疗效果尚未与目前的标准方案 EXTREME（5-氟尿嘧啶、顺铂和西妥昔单抗联合）相比较。

方法

我们回顾性地分析了接受西妥昔单抗为一线治疗的转移性或复发性头颈部鳞状细胞癌（R/M SCCHN）患者的临床病历；从这些患者中，提取了接受每周紫杉醇联合西妥昔单抗方案（队列 A）和 EXTREME 方案（队列 B）的患者。评估了这两个队列的反应、预后和不良事件。

结果

共纳入 86 例患者（队列 A，49 例；队列 B，36 例）。有铂类化疗史的患者更常接受队列 A 治疗。虽然两组的反应率相似（队列 A 为 45%，队列 B 为 51%；p=0.83），但对数秩检验显示队列 A 的无进展生存期（PFS）明显更有利（6.0 个月 vs 5.0 个月；p=0.027）。在 Cox 回归风险分析中，男性（风险比 [HR]=2.1，p=0.010）、年龄较大（≥70 岁）（HR=5.0，p=0.018）、PS 0（HR=2.2，p=0.027）、无铂类化疗史（HR=3.2，p=0.003）和存在气管造口术（HR=2.3，p=0.039）是队列 A 中的有利因素。