Cetuximab, fluorouracil and cisplatin with or without docetaxel for patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (CeFCiD): an open-label phase II randomised trial (AIO/IAG-KHT trial 1108).


Journal

European journal of cancer (Oxford, England : 1990)
ISSN: 1879-0852
Titre abrégé: Eur J Cancer
Pays: England
ID NLM: 9005373

Informations de publication

Date de publication:
11 2019
Historique:
received: 22 06 2019
revised: 21 08 2019
accepted: 28 08 2019
pubmed: 17 10 2019
medline: 29 5 2020
entrez: 17 10 2019
Statut: ppublish

Résumé

The combination of cisplatin, 5-fluorouracil (5-FU) and cetuximab (PFC) is the reference first-line treatment for recurrent/metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN). We analysed whether treatment intensification by the addition of docetaxel to PFC improved efficacy in R/M SCCHN. A total of 180 patients with R/M SCCHN (1:1) were assigned to receive either cisplatin (40 mg/m A preplanned interim analysis for toxicity after 20 patients/arm revealed excessive grade 3 and 4 gastrointestinal (65%) and infectious toxicities (35%) in arm A, which led to dose reduction of cisplatin to 30 mg/m DPFC failed to improve efficacy in R/M SCCHN. On the contrary, a high toxicity and mortality rate was detected in both arms, which underscores the vulnerability of patients with R/M SCCHN, and research on the need for further optimisation of the front-line chemotherapy backbone is ongoing.

Sections du résumé

BACKGROUND
The combination of cisplatin, 5-fluorouracil (5-FU) and cetuximab (PFC) is the reference first-line treatment for recurrent/metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN). We analysed whether treatment intensification by the addition of docetaxel to PFC improved efficacy in R/M SCCHN.
METHODS
A total of 180 patients with R/M SCCHN (1:1) were assigned to receive either cisplatin (40 mg/m
RESULTS
A preplanned interim analysis for toxicity after 20 patients/arm revealed excessive grade 3 and 4 gastrointestinal (65%) and infectious toxicities (35%) in arm A, which led to dose reduction of cisplatin to 30 mg/m
CONCLUSIONS
DPFC failed to improve efficacy in R/M SCCHN. On the contrary, a high toxicity and mortality rate was detected in both arms, which underscores the vulnerability of patients with R/M SCCHN, and research on the need for further optimisation of the front-line chemotherapy backbone is ongoing.

Identifiants

pubmed: 31618704
pii: S0959-8049(19)30478-2
doi: 10.1016/j.ejca.2019.08.018
pii:
doi:

Substances chimiques

Docetaxel 15H5577CQD
Cetuximab PQX0D8J21J
Cisplatin Q20Q21Q62J
Fluorouracil U3P01618RT

Types de publication

Clinical Trial, Phase II Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

53-60

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Auteurs

K Klinghammer (K)

Department of Hematology & Oncology, Charité University, Berlin, Germany. Electronic address: konrad.klinghammer@charite.de.

T Gauler (T)

Department of Radiation Oncology, West German Cancer Center, University of Duisburg-Essen Medical School, Essen, Germany.

A Dietz (A)

Department of Otolaryngology, Head and Neck Surgery, University Leipzig, Leipzig, Germany.

V Grünwald (V)

Interdisciplinary Urooncology, West German Cancer Center, Clinic for Internal Medicine (tumor research) and Clinic for Urology, University of Duisburg-Essen Medical School, Essen, Germany.

J Stöhlmacher (J)

Department of Tumorgenetics Bonn, Bonn, Germany.

S Knipping (S)

Department of Head and Neck Surgery, Klinikum Dessau, Dessau-Roßlau, Germany.

M Schroeder (M)

Department of Hematology and Oncology, Helios Duisburg, Duisburg, Germany.

O Guntinas-Lichius (O)

Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.

N Frickhofen (N)

Department of Hematology & Oncology and Palliative Care, HELIOS Dr Horst Schmidt Kliniken, Wiesbaden, Germany.

H-W Lindeman (HW)

Department of Hematology & Oncology, KKH Hagen, Germany.

R Fietkau (R)

Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

B Haxel (B)

Department of Otolaryngology, AMEOS Klinikum Haldensleben, Haldensleben, Germany; Department of Otolaryngology, Head and Neck Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.

C Große-Thie (C)

Department of Medicine, Clinic III - Hematology, Oncology, Palliative Medicine, Rostock University Medical Center, Rostock, Germany.

G Maschmeyer (G)

Department of Hematology, Oncology and Palliative Care, Klinikum Ernst von Bergmann, Potsdam, Germany.

M Zipfel (M)

Department of Internal Medicine III, University Hospital Bonn, Bonn, Germany.

P Martus (P)

Institute for Clinical Epidemiology and Applied Biometry, University of Tuebingen, Tuebingen, Germany.

M Knoedler (M)

University Cancer Center Leipzig, University Leipzig, Leipzig, Germany.

U Keilholz (U)

Charité Comprehensive Cancer Center, Berlin, Germany.

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Classifications MeSH