my personal edition > head and neck cancer > news


  E-Mail this DGDispatch to a colleague

DGDispatch

Patients With Advanced Head and Neck Cancer Respond Better When Docetaxel Added to Induction Chemotherapy: Presented at ASCO

By Paula Moyer

ORLANDO, FL -- May 25, 2005 -- Adding docetaxel (Taxotere) to induction therapy improves response rates in advanced head and neck squamous cell carcinoma, with a complete pathological response (CPR) rate of 89%, according to findings presented here on May 22^nd at the American Society of Clinical Oncology Annual Meeting (ASCO).

Induction therapy in advanced head and neck squamous cell carcinoma typically consists of 3 cycles of cisplatin (Platinol) and 5-fluorouracil (5-FU). The typical complete pathological response (CPR) is 25% to 50%.

"These results…will in all likelihood translate into a significantly more effective treatment for patients with advanced head and neck cancer," said principal investigator Robert Haddad, MD, medical oncologist, Dana-Farber Cancer Institute, and assistant professor of medicine, Harvard Medical School, Boston, Massachusetts.

On the basis of these findings, the investigative team expects overall survival rates to 95% at 2 years and 90% at 5 years. They are also projecting progression-free survival rates of 85% at each of those time points.

Dr. Haddad said that the typical treatment for advanced head and neck cancer is 3 cycles of induction chemotherapy followed by chemoradiation. However, earlier research showed that adding a taxane to the standard induction regimen was associated with better outcomes and tolerability rates (Hitt et al ASCO 2003, Vermorken et al. ASCO 2004).

Dr. Haddad and colleagues therefore tested a regimen consisting of 3 cycles of induction chemotherapy with docetaxel/cisplatin/5-fluorouracil followed by chemoradiotherapy, which consisted of weekly carboplatin/paclitaxel or docetaxel with standard or concomitant boost radiation.

As per their center's standard practice, the researchers obtained biopsies of the primary site after induction chemotherapy but before chemoradiotherapy.

Among the 72 patients from whom they obtained biopsies, 95% had stage IV disease and 75% had tumors that involved the oropharyngeal area. Biopsies were negative in 64 patients (89%) and positive in 8 patients (11%).

After a median follow-up of 2 years, 25% of the 8 patients with positive biopsies had died of their disease, compared with 4% of those with negative biopsies. Among the 29 patients who underwent postchemotherapy neck dissections, all 7 who were positive were alive, and 4.6% of the 22 who were negative had died.

Dr. Haddad noted that T4 disease did not correlate with a positive biopsy or a positive neck dissection. N3 disease did not correlate with a positive biopsy but was associated with a positive neck dissection (P < .001).

On the basis of their findings, the investigators proposed that docetaxel be added to standard induction chemotherapy for advanced head and neck tumors, Dr. Haddad said.


[Presentation title: Rate of Complete Pathological Responses (pCR) to Docetaxel/Cisplatin/5-Fluorouracil (TPF) Induction Chemotherapy in Patients With Newly Diagnosed, Locally Advanced Squamous Cell Carcinoma of the Head and Neck (SCCHN). Abstract 5511]

E-Mail this DGDispatch to a colleague

To print, use this version