title: A phase II study of pirarubicin in patients with advanced recurrent head and neck squamous cell carcinoma.
abstract: BACKGROUND
  Head and neck squamous carcinoma (HNSCC) is a chemotherapy-sensitive tumour, but this sensitivity is not reflected in an impact on survival. The study of new drugs is therefore indicated. Pirarubicin (4'-O-tetrahydropyranyl-doxorubicin) has a higher preclinical index than doxorubicin, with low cardiotoxicity in animal models.
  
  
  METHODS
  Twenty-six patients with squamous cell carcinoma of the head and neck and documented progression after or during previous chemotherapy were entered into the study. Two patients were ineligible for evaluation. Pirarubicin was given at a dose of 70 mg/m2 every 3 weeks.
  
  
  RESULTS
  Partial remission was seen in 1 of the 24 evaluable patients. The predominant toxicity was bone marrow depression, with leucopenia in 62% of the patients. One patient died due to a gastrointestinal haemorrhage during a period with WHO grade IV thrombocytopenia.
  
  
  CONCLUSIONS
  On the basis of these results, pirarubicin cannot be recommended as second-line treatment in patients with recurrent and metastatic HNSCC. Its possible relevance for first-line treatment cannot be judged from these data.
authors.affiliation: University Hospital, Nijmegen, The Netherlands.
authors.forename: P H
authors.initials: PH
authors.lastname: De Mulder
authors.forename: P
authors.initials: P
authors.lastname: Cappelaere
authors.forename: F
authors.initials: F
authors.lastname: Cognetti
authors.forename: J
authors.initials: J
authors.lastname: Verweij
authors.forename: J H
authors.initials: JH
authors.lastname: Schornagel
authors.forename: J B
authors.initials: JB
authors.lastname: Vermorken
authors.forename: A
authors.initials: A
authors.lastname: Kirkpatrick
authors.forename: J L
authors.initials: JL
authors.lastname: Lefebvre
mesh_terms: D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000556:secondary; D004317:Doxorubicin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin; C027260:pirarubicin