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Induction chemotherapy and cetuximab for locally advanced squamous cell carcinoma of the head and neck: Results from a phase II prospective trial
Journal of Clinical Oncology, 11/25/09

Kies MS et al. – ICT with weekly PCC followed by risk-based local therapy seems to be feasible, effective, and well tolerated. PFS is promising, and this sequential treatment strategy should be further investigated. Patients with HPV-positive tumors have an excellent prognosis.

• 47 previously untreated patients (41 with oropharynx primaries; 33 men, 14 women; median age, 53 years; performance status of 0 or 1) with squamous cell carcinoma of head and neck (SCCHN; T1-4, N2b/c/3) treated and evaluated for clinical and radiographic response
• After ICT, patients underwent risk-based local therapy, which consisted of either radiation, concomitant chemoradiotherapy, or surgery, based on tumor stage and site at diagnosis

• After induction PCC, nine patients (19%) achieved a complete response, and 36 patients (77%) achieved partial response
• Most common grade 3 or 4 toxicity was skin rash (45%), followed by neutropenia (21%) without fever
• At median follow-up time of 33 months, locoregional or systemic disease progression observed in 6 patients
• 3-year PFS and OS rates 87% (95% CI, 78% to 97%) and 91% (95% CI, 84% to 99%), respectively
• HPV 16, found in 12 (46%) of 26 biopsies, associated with improved PFS and OS

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