Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa-shi, Chiba, 277-8577, Japan.
Int J Clin Oncol. 2022 Nov;27(11):1669-1674. doi: 10.1007/s10147-022-02226-5. Epub 2022 Aug 9.
Cetuximab (Cmab) plays an important role in the treatment for recurrent or metastatic head and neck cancer (R/M HNC). To date, however, no safety data on biweekly administration of cetuximab at a dose of 500 mg/m (biweekly Cmab) for Japanese HNC patients have been available.
We retrospectively reviewed the clinical records of five R/M HNC patients who received biweekly Cmab in our institute between January 2016 and September 2021 and compared the safety profile between two phases of weekly 250 mg/m and biweekly 500 mg/m Cmab in the identical patients.
All patients initially received Cmab in combination with chemotherapy. Chemotherapy consisted of paclitaxel plus carboplatin in two patients, cisplatin + 5-FU in one patient, and paclitaxel in two patients. Three patients switched treatment schedule from weekly Cmab to biweekly Cmab, while two patients received biweekly Cmab after completion of chemotherapy. The main reason for switching to biweekly Cmab was an unacceptably long commuting time to the hospital. The median duration of Cmab was 217 days (49-321) during weekly Cmab with or without chemotherapy and 42 days (28-175) during biweekly Cmab. Median dose of biweekly Cmab was 4 (3-12). During biweekly Cmab, worsened (Grade ≥ 2) toxicities were observed in two patients: one with grade 2 dry skin and the second with grade 2 skin infection. None developed grade ≥ 3 adverse events or discontinued treatment due to Cmab-related adverse events.
Biweekly Cmab was well tolerated and did not demonstrate severe toxicities related to Cmab for R/M HNC.
西妥昔单抗（Cmab）在复发性或转移性头颈部癌症（R/M HNC）的治疗中发挥着重要作用。然而，迄今为止，尚无关于日本 HNC 患者每周两次给予 500mg/m 剂量的西妥昔单抗（biweekly Cmab）的安全性数据。
我们回顾性分析了 2016 年 1 月至 2021 年 9 月期间在我院接受每周两次 500mg/m 西妥昔单抗治疗的 5 例 R/M HNC 患者的临床记录，并比较了同一患者每周 250mg/m 和每周两次 500mg/m 西妥昔单抗两个阶段的安全性。
所有患者最初均接受西妥昔单抗联合化疗。2 例患者化疗方案为紫杉醇+卡铂，1 例患者为顺铂+5-FU，2 例患者为紫杉醇。3 例患者将治疗方案从每周西妥昔单抗改为每周两次西妥昔单抗，2 例患者在化疗结束后接受每周两次西妥昔单抗。改为每周两次西妥昔单抗的主要原因是往返医院的时间过长。每周 Cmab 联合或不联合化疗时，西妥昔单抗的中位治疗时间为 217 天（49-321），每周两次 Cmab 时为 42 天（28-175）。每周两次 Cmab 的中位剂量为 4（3-12）。在每周两次 Cmab 时，有 2 例患者出现恶化（≥2 级）毒性：1 例为 2 级皮肤干燥，另 1 例为 2 级皮肤感染。无患者发生≥3 级不良事件或因 Cmab 相关不良事件而停止治疗。
每周两次 Cmab 耐受性良好，不会引起与 Cmab 相关的严重毒性。
