title: Cetuximab, docetaxel, and cisplatin as first-line treatment in patients with recurrent or metastatic head and neck squamous cell carcinoma: a multicenter, phase II GORTEC study.
abstract: BACKGROUND
  Cetuximab in combination with platinum and 5-fluorouracil is the standard of care in the first-line treatment of patients with recurrent/metastatic head and neck squamous cell carcinoma (HNSCC). Cetuximab and taxane combinations have shown promising activity. This study evaluated the efficacy and safety of four cycles of docetaxel associated with cisplatin and cetuximab (TPEx), followed by maintenance with cetuximab every 2 weeks.
  
  
  METHODS
  Patients with a histologically confirmed HNSCC with metastasis or recurrence unsuitable for locoregional curative treatment received docetaxel and cisplatin (75 mg/m(2) both) at day 1 and weekly cetuximab 250 mg/m(2) (loading dose of 400 mg/m(2)), repeated every 21 days for four cycles, followed by maintenance cetuximab 500 mg/m(2) every 2 weeks until progression or unacceptable toxicity. Prophylactic administration of granulocyte colony-stimulating factor was done systematically after each chemotherapy cycle. Patients had a good general status (performance status ≤1) and were under 71 years. Prior total doses of cisplatin exceeding 300 mg/m(2) were not allowed. The primary end point was objective response rate (ORR) after four cycles.
  
  
  RESULTS
  Fifty-four patients were enrolled. The primary end point was met with an ORR of 44.4% (95% CI 30.9-58.6). Median overall and progression-free survivals were, respectively, 14 months (95% CI 11.3-17.3) and 6.2 months (95% CI 5.4-7.2). The most common grade 3/4 adverse events were skin rash (16.6%) and non-febrile neutropenia (20.4%). There were one pulmonary embolism and two infectious events leading to death.
  
  
  CONCLUSIONS
  The TPEx regimen showed promising activity as first-line treatment in fit patients with recurrent/metastatic HNSCC. Further studies are needed to compare the TPEx versus EXTREME regimen in this population.
  
  
  BACKGROUND
  NCT01289522.
authors.affiliation: Department of Medical Oncology, Centre Antoine Lacassagne, Nice; Gustave Roussy, UMR 8126/CNRS, Villejuif. Electronic address: joel.guigay@nice.unicancer.fr.
authors.forename: J
authors.initials: J
authors.lastname: Guigay
authors.affiliation: Department of Medical Oncology, University of Lyon, Centre Léon Bérard, and Hospices Civils de Lyon, Lyon.
authors.forename: J
authors.initials: J
authors.lastname: Fayette
authors.affiliation: Department of Medical Oncology, Centre Jean Perrin, Clermont-Ferrand.
authors.forename: A F
authors.initials: AF
authors.lastname: Dillies
authors.affiliation: Department of Medical Oncology, Hôpital Bretagne Sud, Lorient, France.
authors.forename: C
authors.initials: C
authors.lastname: Sire
authors.affiliation: Department of Medical Oncology, CHU Dinant Godinne UCL, Namur, Belgium.
authors.forename: J N
authors.initials: JN
authors.lastname: Kerger
authors.affiliation: Department of Medical Oncology, Centre Henri Becquerel, Rouen, France.
authors.forename: I
authors.initials: I
authors.lastname: Tennevet
authors.affiliation: Department of Medical Oncology, Institut Roi Albert II, Cliniques Universitaires St-Luc and Institut de Recherche Clinique et Expérimentale (Pôle Miro), Université Catholique de Louvain, Brussels, Belgium.
authors.forename: J P
authors.initials: JP
authors.lastname: Machiels
authors.affiliation: Department of Medical Oncology, Centre Georges François Leclerc, Dijon.
authors.forename: S
authors.initials: S
authors.lastname: Zanetta
authors.affiliation: Department of Medical Oncology, CHRU de Tours, Tours.
authors.forename: Y
authors.initials: Y
authors.lastname: Pointreau
authors.affiliation: Department of Medical Oncology, Institut Curie-Hôpital René Huguenin, Saint-Cloud, France.
authors.forename: L
authors.initials: L
authors.lastname: Bozec Le Moal
authors.affiliation: Department of Medical Oncology, Clinique Sainte-Elisabeth, Namur, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Henry
authors.affiliation: Department of Head and Neck Oncology, Gustave Roussy, Villejuif, France.
authors.forename: A
authors.initials: A
authors.lastname: Schilf
authors.affiliation: GORTEC, Lausanne, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Bourhis
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy*; D000068818:Cetuximab / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use*; D018450:Disease Progression; D018572:Disease-Free Survival; D000077143:Docetaxel; D004334:Drug Administration Schedule; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006258:Head and Neck Neoplasms / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D000077195:Squamous Cell Carcinoma of Head and Neck; D043823:Taxoids / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D043823:Taxoids; D016179:Granulocyte Colony-Stimulating Factor; D000077143:Docetaxel; D000068818:Cetuximab; D002945:Cisplatin
keywords: cetuximab; chemotherapy; docetaxel; first line; head and neck cancer; maintenance