Gefitinib aids chemoradiotherapy in head and neck cancer

NEW YORK (Reuters Health) - The epidermal growth factor receptor (EGFR) inhibitor gefitinib is a useful addition to treatment of patients with locally advanced head and neck cancer, researchers report in a May 24th online paper in the Journal of Clinical Oncology.

As Dr. Ezra E.W. Cohen told Reuters Health by email, "This phase two study incorporating a targeted agent against epidermal growth factor receptor inhibitor demonstrates that we can reduce toxicity by substituting these agents for chemotherapy while preserving efficacy."

Dr. Cohen of the University of Chicago and colleagues studied 69 patients with a median age of 55 years. The received 2 cycles of carboplatin/paclitaxel induction chemotherapy followed by split-course concurrent chemoradiotherapy with fluorouracil, hydroxyurea, twice daily radiotherapy and gefitinib (250 mg daily). This was followed by continued gefitinib for a total of 2 years.

In the 31 patients for whom data were available, high EGFR gene copy number was associated with worse overall survival. There was no association between gene copy number and response to chemoradiotherapy.

Overall, the complete remission rate after concurrent chemoradiotherapy was 90%. After a median follow-up of 3.5 years, 4-year overall, progression-free, and disease-specific survival rates were 74%, 72%, and 89%.

"In addition," concluded Dr. Cohen, "it is intriguing to note that only one patient developed a second primary tumor in high-risk areas thus far, and we hypothesize that maintaining gefitinib for an extended period of time, in this study for 2 years, after completing definitive therapy is beneficial."

http://jco.ascopubs.org/cgi/content/abstract/JCO.2009.27.0397v1

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