title: Safety of combination treatment with imatinib mesylate, carboplatin, and cetuximab in a patient with multiple cancers: a case report.
abstract: OBJECTIVE
  Therapies directed against multiple signaling pathways have been validated in the clinical setting as effective anticancer treatments. The combination of different agents is particularly helpful in patients with multiple cancer diagnoses, while data on cross-toxicity are frequently missing, as for imatinib and cetuximab plus platinum drugs.
  
  
  METHODS
  We present the case of a 76-year-old man with advanced laryngeal squamous cell carcinoma and chronic myeloid leukemia (CML). Combined treatment with imatinib mesylate and cetuximab plus carboplatin was well-tolerated by the patient, who did not develop neutropenia. By an interdisciplinary approach with hematology specialists, the anticipated neutropenia was managed by the temporary interruption of imatinib treatment when the white blood cell (WBC) count nadir was expected to occur.
  
  
  RESULTS
  Although treatment with imatinib, carboplatin, and cetuximab can be associated with hematologic toxicities, a combination regimen based on the concomitant administration of these 3 drugs and on the discontinuation of imatinib at the predicted nadir of WBC count was feasible and well-tolerated in a patient with concomitant CML and locally advanced laryngeal squamous cell carcinoma.
  
  
  CONCLUSIONS
  Our report indicates the feasibility of combination imatinib and cetuximab plus carboplatin in a case of multiple cancer diagnoses, provided that the treatment with imatinib is modulated according to the expected bone marrow depression.
authors.affiliation: Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan - Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Pala
authors.affiliation: Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan - Italy.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Bergamini
authors.affiliation: Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan - Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Imbimbo
authors.affiliation: Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan - Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Granata
authors.affiliation: Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan - Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Locati
authors.affiliation: Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan - Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Alfieri
authors.affiliation: Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan - Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Licitra
authors.affiliation: Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan - Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bossi
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001706:Biopsy; D016190:Carboplatin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000188:drug therapy; D000068818:Cetuximab / Q000008:administration & dosage; D006801:Humans; D000068877:Imatinib Mesylate / Q000008:administration & dosage; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000188:drug therapy; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed
chemical_list: D000068877:Imatinib Mesylate; D016190:Carboplatin; D000068818:Cetuximab