Docetaxel in squamous cell cancer of the head and neck.
Single-agent docetaxel induces a response in 21-42% of patients with recurrent squamous cell cancer of the head and neck (SCCHN). When used in combination with 5-fluorouracil (5-FU), response rates (RRs) of between 24 and 27% have been reported. In contrast, in combination with cisplatin, docetaxel has achieved a RR of 33% in previously treated patients and 86% in a subgroup of chemotherapy-naive advanced stage patients. The docetaxel/cisplatin combination appears to be highly active. High-dose induction chemotherapy for patients with locally advanced but potentially curable SCCHN is producing promising results: following combination therapy involving docetaxel, cisplatin, 5-FU and leucovorin (TPFL), RR are high and 75% of patients are alive at 2 years. Intermediate-dose induction chemotherapy involving docetaxel is also promising: the TAX 708 trial found an excellent 93% RR in 41 evaluable patients treated with docetaxel plus cisplatin and 5-FU (TPF). The rate of pathological complete response was also high. The toxicities with TPF therapy were similar to those seen with cisplatin/5-FU regimens without docetaxel. A phase III trial of this approach is currently being conducted.
Posner
M R
MR
Department of Adult Oncology, Head and Neck Oncology Program, Dana-Farber Cancer Institute, Boston, MA 02115, USA. marshall_posner@dfci.harvard.edu
D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy*; D000077143:Docetaxel; D006258:Head and Neck Neoplasms / Q000188:drug therapy*; D006801:Humans; D017239:Paclitaxel / Q000031:analogs & derivatives / Q000627:therapeutic use*; D043823:Taxoids
D000972:Antineoplastic Agents, Phytogenic; D043823:Taxoids; D000077143:Docetaxel; D017239:Paclitaxel