title: Clinical benefit of nanoparticle albumin-bound-paclitaxel in recurrent/metastatic head and neck squamous cell carcinoma resistant to cremophor-based paclitaxel or docetaxel.
abstract: The clinical benefit of nab-paclitaxel monotherapy for recurrent/metastatic head and neck squamous cell carcinoma (RM-HNSCC) that progressed on other taxanes (cremophor-based paclitaxel or docetaxel) is unknown. A retrospective analysis of patients treated at a single institution with nab-paclitaxel for taxane-resistant RM-HNSCC. The exploratory hypothesis was that nab-paclitaxel would result in clinical benefit (tumor response) in patients with taxane-resistant RM-HNSCC. Twelve patients who were treated with nab-paclitaxel monotherapy for taxane-resistant RM-HNSCC and met all eligibility criteria were identified. The majority of patients (n = 9; 75%) received three or more lines of therapy for RM-HNSCC. All patients had platin-resistant, and ten patients (83%) had cetuximab-resistant disease. Patients had RM-HNSCC that progressed on cremophor-based paclitaxel (8), docetaxel (1), or both (3). With prior taxane, the best tumor response was partial (PR) in 4 patients (33%), stable (SD) in 3 (25%), and progression in 5 (42%). The median time-to-progression (TTP) with prior taxane was 1.7 (range 0.7-9.0) months. The median interval from last dose of taxane to first dose of nab-paclitaxel was 3 (0.7-31.3) months. With nab-paclitaxel, tumor response occurred in two patients (17%; PR in both) and disease control (PR and SD) occurred in five (42%). Median TTP with nab-paclitaxel was 2.1 months (range 0.6-6.2), and median overall survival was 4.9 months (range 1.9-13.5). nab-Paclitaxel provided clinical benefit in some patients with taxane-resistant RM-HNSCC. The median TTP with nab-paclitaxel and with prior taxane were similar. This exploratory observation warrants further investigation in prospective studies.
authors.affiliation: Division of Medical Oncology, Department of Internal Medicine, Washington University School of Medicine, 660 South Euclid, Campus Box 8056, St. Louis, MO, 63110, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Ley
authors.affiliation: Division of Medical Oncology, Department of Internal Medicine, Washington University School of Medicine, 660 South Euclid, Campus Box 8056, St. Louis, MO, 63110, USA.|Alvin J. Siteman Cancer Center, Washington University School of Medicine, 660 South Euclid, Campus Box 8056, St. Louis, MO, 63110, USA.
authors.forename: Tanya M
authors.initials: TM
authors.lastname: Wildes
authors.affiliation: Division of Medical Oncology, Department of Internal Medicine, Washington University School of Medicine, 660 South Euclid, Campus Box 8056, St. Louis, MO, 63110, USA.|Alvin J. Siteman Cancer Center, Washington University School of Medicine, 660 South Euclid, Campus Box 8056, St. Louis, MO, 63110, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Daly
authors.affiliation: Division of Medical Oncology, Department of Internal Medicine, Washington University School of Medicine, 660 South Euclid, Campus Box 8056, St. Louis, MO, 63110, USA.|Alvin J. Siteman Cancer Center, Washington University School of Medicine, 660 South Euclid, Campus Box 8056, St. Louis, MO, 63110, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Oppelt
authors.affiliation: Division of Medical Oncology, Department of Internal Medicine, Washington University School of Medicine, 660 South Euclid, Campus Box 8056, St. Louis, MO, 63110, USA. dadkins@wustl.edu.|Alvin J. Siteman Cancer Center, Washington University School of Medicine, 660 South Euclid, Campus Box 8056, St. Louis, MO, 63110, USA. dadkins@wustl.edu.
authors.forename: Douglas
authors.initials: D
authors.lastname: Adkins
mesh_terms: D000328:Adult; D000368:Aged; D000068196:Albumin-Bound Paclitaxel / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D000077143:Docetaxel; D019008:Drug Resistance, Neoplasm; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D017239:Paclitaxel / Q000008:administration & dosage / Q000494:pharmacology; D011092:Polyethylene Glycols / Q000008:administration & dosage; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D043823:Taxoids / Q000494:pharmacology
chemical_list: D000068196:Albumin-Bound Paclitaxel; D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel; C022131:cremophor; D011092:Polyethylene Glycols; D017239:Paclitaxel
keywords: Clinical benefit; Cremophor-based paclitaxel; Recurrent/metastatic HNSCC; nab-paclitaxel