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Phase I and initial phase II results from a trial investigating weekly docetaxel and carboplatin given neoadjuvantly and then concurrently with concomitant boost radiotherapy for locally advanced squamous cell carcinoma of the head and neck
Author(s) -
Schwartz David L.,
Montgomery R. Bruce,
Yueh Bevan,
Donahue Michael,
Anzai Yoshimi,
Canby Raylene,
Buelna Raelene,
Anderson Leslie,
Boyd Charles,
Hutson Janice,
Keegan Kathryn
Publication year - 2005
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.21085
Subject(s) - medicine , docetaxel , carboplatin , mucositis , chemoradiotherapy , concomitant , radiation therapy , surgery , induction chemotherapy , head and neck squamous cell carcinoma , progressive disease , oncology , chemotherapy , head and neck cancer , cisplatin
BACKGROUND The current Phase I/II study assessed induction docetaxel/carboplatin given weekly for 4 weeks, followed by weekly docetaxel/carboplatin and concomitant boost radiotherapy (CB‐XRT) for locally advanced head and neck squamous cell carcinoma. METHODS Twenty patients with Stage III or IV (M0) disease of the oropharynx, supraglottic larynx, or hypopharynx were enrolled. Patients initially received docetaxel 20 mg/m 2 and carboplatin area under the curve (AUC) 2 weekly × 4. Patients with stable (SD) or responding disease subsequently received dose‐escalated docetaxel (10–20 mg/m 2 in sequential patient cohorts) and carboplatin AUC 1 weekly × 5 with CB‐XRT (1.8 gray [Gy] every day × 15 days, followed by 1.8/1.5 Gy twice per day × 13 days). RESULTS All patients were evaluable, and 15 patients (5 patients with Stage III disease, 10 patients with Stage IV disease) completed all planned therapy. The target docetaxel dose level of 20 mg/m 2 weekly with radiotherapy was achieved with no dose‐limiting toxicities. The most frequent maximum toxicities during chemoradiotherapy were Grade 3 mucositis, dysphagia, and/or pain. Primary site responses after induction included 4 patients with partial responses, 11 patients with SD, and 5 patients with disease progression. Fifteen patients (75%) continued to receive chemoradiotherapy, with 14 patients attaining a complete response (CR). Overall, a clinicopathologic neck CR after chemoradiotherapy was achieved in 9 of 10 patients. One patient had persistent primary disease and underwent salvage surgery, whereas another died of unrelated causes before neck assessment. Thirteen patients remain free of any disease event, with a median follow‐up of 15 months (range, 3–29 months). CONCLUSIONS This regimen was feasible, safe, and particularly well tolerated. Early Phase II outcomes revealed promising activity in patients completing all treatment. Initial induction response results suggested that further investigation of this regimen with more aggressive induction therapy is warranted. Cancer 2005. © 2005 American Cancer Society.