Comparison of the efficacy and safety of the EXTREME regimen for treating recurrent or metastatic head and neck squamous cell carcinoma in older and younger adult patients.
Adult
Age Factors
Aged
Antineoplastic Combined Chemotherapy Protocols
/ administration & dosage
Cetuximab
/ administration & dosage
Chemoradiotherapy
/ adverse effects
Chemotherapy, Adjuvant
/ adverse effects
Cisplatin
/ administration & dosage
Drug-Related Side Effects and Adverse Reactions
/ diagnosis
Female
Fluorouracil
/ administration & dosage
Geriatric Assessment
/ statistics & numerical data
Head and Neck Neoplasms
/ mortality
Humans
Incidence
Male
Middle Aged
Neoplasm Recurrence, Local
/ diagnosis
Nutritional Status
Patient Selection
Progression-Free Survival
Retrospective Studies
Risk Assessment
/ methods
Severity of Illness Index
Squamous Cell Carcinoma of Head and Neck
/ mortality
biomarkers
cancer care
chemotherapy
head and neck cancer
nutrition
Journal
Cancer reports (Hoboken, N.J.)
ISSN: 2573-8348
Titre abrégé: Cancer Rep (Hoboken)
Pays: United States
ID NLM: 101747728
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
revised:
22
10
2020
received:
11
08
2020
accepted:
27
10
2020
pubmed:
10
12
2020
medline:
30
11
2021
entrez:
9
12
2020
Statut:
ppublish
Résumé
Head and neck squamous cell carcinoma (HNSCC) is a geriatric cancer. However, older adult patients are frequently underrepresented in large clinical trials. The aim of this study is to assess the efficacy and safety of the EXTREME regimen (platinum + fluorouracil + cetuximab) in older and younger adult patients with HNSCC. Patients with recurrent or metastatic HNSCC treated with the EXTREME regimen were retrospectively analyzed. We compare the efficacy and safety in older (aged ≥70 years) younger (aged <70 years) adult patients. Of the 86 patients examined in this study, 21 (24.4%) were older adults. There was no difference in overall response rate (46.9% vs 38.5%, P = .76), median progression-free survival [5.7 months vs 5.8 months, hazard ratio (HR) 0.88, 95% confidence interval (CI) = 0.52-1.51, P = .66] and overall survival (OS) (14.6 months vs 15.2 months, HR 0.79, 95% CI 0.43-1.43, P = .44) in younger vs older patients. There was also no difference in the incidence of grade 3/4 adverse events between groups. The exploratory analysis for geriatric nutritional risk index (GNRI) showed the association with lower GNRI (≤98) and poor OS in older adult patients (37.7 months vs 7.0 months, HR 0.53, 95% CI 0.31-0.89, P = .002). The EXTREME regimen with optimal dose modification is safe and effective for both older and younger adult patients with HNSCC. The GNRI can be an indicator to select the older adult patients who can get benefit from the EXTREME regimen.
Sections du résumé
BACKGROUND
Head and neck squamous cell carcinoma (HNSCC) is a geriatric cancer. However, older adult patients are frequently underrepresented in large clinical trials.
AIMS
The aim of this study is to assess the efficacy and safety of the EXTREME regimen (platinum + fluorouracil + cetuximab) in older and younger adult patients with HNSCC.
METHODS AND RESULTS
Patients with recurrent or metastatic HNSCC treated with the EXTREME regimen were retrospectively analyzed. We compare the efficacy and safety in older (aged ≥70 years) younger (aged <70 years) adult patients. Of the 86 patients examined in this study, 21 (24.4%) were older adults. There was no difference in overall response rate (46.9% vs 38.5%, P = .76), median progression-free survival [5.7 months vs 5.8 months, hazard ratio (HR) 0.88, 95% confidence interval (CI) = 0.52-1.51, P = .66] and overall survival (OS) (14.6 months vs 15.2 months, HR 0.79, 95% CI 0.43-1.43, P = .44) in younger vs older patients. There was also no difference in the incidence of grade 3/4 adverse events between groups. The exploratory analysis for geriatric nutritional risk index (GNRI) showed the association with lower GNRI (≤98) and poor OS in older adult patients (37.7 months vs 7.0 months, HR 0.53, 95% CI 0.31-0.89, P = .002).
CONCLUSIONS
The EXTREME regimen with optimal dose modification is safe and effective for both older and younger adult patients with HNSCC. The GNRI can be an indicator to select the older adult patients who can get benefit from the EXTREME regimen.
Identifiants
pubmed: 33295110
doi: 10.1002/cnr2.1322
pmc: PMC8451378
doi:
Substances chimiques
Cetuximab
PQX0D8J21J
Cisplatin
Q20Q21Q62J
Fluorouracil
U3P01618RT
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1322Informations de copyright
© 2020 The Authors. Cancer Reports published by Wiley Periodicals LLC.
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