title: Is the combination of Cetuximab with chemo-radiotherapy regimens worthwhile in the treatment of locally advanced head and neck cancer? A review of current evidence.
abstract: The administration of Cetuximab in combination with radiotherapy and chemotherapy has shown clear survival improvements within the locally advanced and the relapsed/metastatic settings respectively. These results have provided the clinical rational for the inclusion of Cetuximab into chemo-radiation regimens. Trials assessing the combination of Cetuximab with induction chemotherapy, concomitant chemo-radiotherapy or both are reviewed. Taken together, their results suggest that the addition of Cetuximab is promising in trials of induction chemotherapy, showing almost uniformly response rates higher than historical controls. In combination with concomitant hyperfractionated radiotherapy and Cisplatin the results of the RTOG 0522 trial do not suggest any benefit. However a positive effect cannot be excluded with other schedules. Although feasibility has been universally suggested, adding Cetuximab implies some toxicity enhancement. Single local and systemic toxicities are more frequent and supposedly the overall treatment intensity is increased. Moreover the drug-specific toxicities are potentially severe and deserve timely recognition and management.
authors: Medical Oncology Department, Ospedale U. Parini, Aosta, Italy. gnumico@ausl.vda.it
authors: Gianmauro
authors: G
authors: Numico
authors: Pierfrancesco
authors: P
authors: Franco
authors: Antonella
authors: A
authors: Cristofano
authors: Fernanda
authors: F
authors: Migliaccio
authors: Silvia
authors: S
authors: Spinazzé
authors: Nicola
authors: N
authors: Silvestris
authors: Domenico
authors: D
authors: Cante
authors: Piera
authors: P
authors: Sciacero
authors: Maria Rosa
authors: MR
authors: La Porta
authors: Franco
authors: F
authors: Girelli
authors: Umberto
authors: U
authors: Ricardi
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000068818:Cetuximab; D003131:Combined Modality Therapy; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D009367:Neoplasm Staging; D011379:Prognosis
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068818:Cetuximab