Phase II trial of pemetrexed-based induction chemotherapy followed by concomitant chemoradiotherapy in previously irradiated patients with squamous cell carcinoma of the head and neck

V. M. Villaflor, D. Haraf, J. K. Salama, M. Kocherginsky, A. Langerman, G. Gomez-Abuin, P. Beniwal, E. A. Blair, K. M. Stenson, L. Portugal, T. Seiwert, R. D. Williams, A. J. Dekker, M. E. Witt, E. E. Vokes, E. E.W. Cohen

Research output: Contribution to journalArticle

Abstract

Background: Concurrent chemoreirradiation therapy (CRRT) offers a therapeutic option for patients with locoregionally recurrent squamous cell carcinoma of the head and neck (SCCHN). We hypothesized that response to induction chemotherapy (IC) would improve outcome and predict increased survival. Patients and methods: Subjects with recurrent SCCHN not amenable to standard therapy were eligible. IC consisted of two 28-day cycles of gemcitabine and pemetrexed on days 1 and 14, followed by surgical resection, if appropriate, and/or CRRT consisting of carboplatin, pemetrexed, and single daily fractionated radiotherapy. Results: Thirty-five subjects were enrolled, 31 were assessable for response, with 11 responders [response rate = 35%; 95% confidence interval (CI) 19.2-54.6]. Among 24 subjects who started CRRT, 11 were assessable for radiographic response, 4 complete response, 2 partial response, and 5 progressive disease. Median progression-free survival and overall survival (OS) were 5.5 months (95% CI 3.6-8.3) and 9.5 months (95% CI 7.2-15.4), respectively. One-year OS was 43% (95% CI 26% to 58%). Subjects who responded to IC had improved survival (P = 0.02). Toxic effects included mucositis, dermatitis, neutropenia, infection, hemorrhage, dehydration, and pain. Conclusions: The combination of pemetrexed plus gemcitabine was active and well tolerated in recurrent SCCHN. Response to IC may help stratify prognosis and offer an objective and dynamic metric in recurrent SCCHN patients being considered for CRRT.

Original languageEnglish (US)
Pages (from-to)2501-2507
Number of pages7
JournalAnnals of Oncology
Volume22
Issue number11
DOIs
StatePublished - Nov 1 2011
Externally publishedYes

Keywords

  • Chemoreirradiation
  • Concurrent chemoradiation
  • Induction chemotherapy
  • Recurrent head and neck cancer

ASJC Scopus subject areas

  • Hematology
  • Oncology

Fingerprint Dive into the research topics of 'Phase II trial of pemetrexed-based induction chemotherapy followed by concomitant chemoradiotherapy in previously irradiated patients with squamous cell carcinoma of the head and neck'. Together they form a unique fingerprint.

  • Cite this

    Villaflor, V. M., Haraf, D., Salama, J. K., Kocherginsky, M., Langerman, A., Gomez-Abuin, G., Beniwal, P., Blair, E. A., Stenson, K. M., Portugal, L., Seiwert, T., Williams, R. D., Dekker, A. J., Witt, M. E., Vokes, E. E., & Cohen, E. E. W. (2011). Phase II trial of pemetrexed-based induction chemotherapy followed by concomitant chemoradiotherapy in previously irradiated patients with squamous cell carcinoma of the head and neck. Annals of Oncology, 22(11), 2501-2507. https://doi.org/10.1093/annonc/mdq785