In case of death related to cancer without an accurate date of progression before death, the patient will be considered in progression at the time of death.

Press cancel to remain on ReachMD. Weekly Low-Dose Versus Three-Weekly High-Dose Cisplatin for Concurrent Chemoradiation in Locoregionally Advanced Non-Nasopharyngeal Head and Neck Cancer: A Systematic Review and Meta-Analysis of Aggregate Data. Half of patients will be treated by TPEx regimen, while the other half will be treated by EXTREME regimen. Our site requires a computer, tablet or mobile device and a connection to the Internet. Groupe Oncologie Radiotherapie Tete et Cou, Grupo Español de Tratamiento de Tumores de Cabeza y Cuello. Conclusions: IC with TPEx followed by cetuximab with concurrent radiotherapy showed acceptable compliance for the treatment of LA SCCHN. Previous chemotherapy treatments:  The burden of cisplatin received in time from last dose of the cisplatin condition our selection of treatment. Especially in Asia and in China, the head and neck actually has higher incidence, and the treatment has not been uniform. Taking together all these considerations, the TPEx regimen might be a good substitute for EXTREME as first-line treatment in patients with recurrent metastatic HNSCC, and it is justified and necessary to perform a direct comparison in a randomized trial to further test this hypothesis. .
Dr. Mesia:Immune checkpoint inhibitors could produce an inflammation in any body organ. However, pembrolizumab, while available in China, is not currently approved for the treatment of recurrent or metastatic squamous cell carcinoma of the head and neck. How to Approach Liquid Biopsy in the Treatment of NSCLC, The Changing Landscape of NSCLC: MET Inhibitors, Acquired Resistance to Targeted Therapy of NSCLC: A Global Perspective, Actualización sobre inmunoterapia: tratamiento de carcinoma recurrente o metastásico de células escamosas de la cabeza y el cuello, Long-Term Efficacy & Safety of HPV Vaccination. J Natl Cancer Inst. continuous infusion).

Significant disease which, in the judgment of the investigator, would make the patient inappropriate for entry into the trial. Announcer:You have been listening to CME on ReachMD. Conclusions: IC with TPEx followed by cetuximab with concurrent radiotherapy showed acceptable compliance for the treatment of LA SCCHN. This is CME on ReachMD, and I am Dr. Anna Castro. It has had not much progression in the past 20 years until recently with the introduction of immunotherapy. This site needs JavaScript to work properly.

If cisplatin is not tolerated and/or when the total cumulative dose of cisplatin (including prior administration) reaches 600 mg/m², cisplatin has to be replaced by carboplatin, AUC 5 (but not exceeding 750 mg), except in the case of bleeding tumor. -. Health related quality of life (QoL) assessed by EORTC QLQ-C30. And finally, based on the KEYNOTE-048 trial, we have the possibility of treating these patients with pembrolizumab alone or pembrolizumab plus platinum plus 5-FU. For best results, a high-speed Internet connection is recommended (DSL/cable). See this image and copyright information in PMC. AU Guigay J, Fayette J, Mesia R, Lafond C, Saada-Bouzid S 10.1093/jnci/86.4.265

Patients with nasopharyngeal cancer, paranasal sinus cancer or unknown primary, Prior systemic chemotherapy for the head and neck carcinoma, except if given as part of a multimodal treatment for locally advanced disease which was completed more than 6 months prior to study entry, Surgery (excluding diagnostic biopsy) or radiotherapy within 6 weeks before study entry, Known dihydropyrimidine dehydrogenase (DPD) deficiency, Recent or planed yellow fever vaccination, Prior dose of cisplatin > 300 mg/m² (a patient who received prior RT + 3 cycles of cisplatin or 3 cycles induction TPF, i.e. Essentially, what are we learning from the data emerging from KEYNOTE-048. The Evolving Role of Taxanes in Combination With Cetuximab for the Treatment of Recurrent and/or Metastatic Squamous Cell Carcinoma of the Head and Neck: Evidence, Advantages, and Future Directions. USA.gov.

When comparing patient outcomes for overall survival in KEYOTE-048, pembrolizumab plus  chemotherapy was superior to EXTREME whether the combined positive score results, or CPS for PD-L1 status, was ≥20 or or ≥1; this outcome also extended to the overall population regardless of PD-L1 status. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients’ conditions and possible contraindications or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. 2015 Sep;26(9):1941-1947. doi: 10.1093/annonc/mdv268. Other factors that could influence in the election is nutritional status or patients' preferences. Objective response rate (complete response (CR) or partial response (PR) according to RECIST 1.1 criteria and assessed by central imaging review) at 12 weeks. Best overall tumor response rate (RECIST 1.1 criteria) during chemotherapy and maintenance: CR or PR or SD confirmed for CR or PR by a second assessment 6 weeks later. In this regard, the poor outcomes associated with recurrent/metastatic squamous cell carcinoma of the head and neck represent a significant unmet medical need. J Natl Cancer Inst. (2007) 357:1705–15. For the statistical analysis patients not evaluable (whatever the reason, including death) will be considered as failure (i.e. Patients with disease progression may be treated with off protocol therapy but will be followed for overall survival evaluation. Reproduction of this material is not permitted without written permission from the copyright owner. Negative pregnancy test in women of childbearing potential within 14 days prior to treatment initiation (premenopausal or less than 12 months of amenorrhea post-menopause, and who have not undergone surgical sterilization). The frequencies of grade ≥3 febrile neutropenia or allergy/infusion reactions were 39% and 11%, respectively. . For those patients with a high tumor burden, we will prefer a combination of chemo plus pembrolizumab. In front of this, we need also to consider they are usually very symptomatic, usually with swallowing problems, breathing problems, bleeding, pain, weight loss and infections, and most importantly, most of them are usually presenting with comorbidities like COPD, anemia, hepatitis. 2017 Sep;22(9):1056-1066. doi: 10.1634/theoncologist.2017-0015. Rapidis AD, Trichas M, Stavrinidis E, Roupakia A, Ioannidou G, Kritselis G, Liossi P, Giannakouras G, Douzinas EE, Katsilieris I. Get the latest research information from NIH: You have reached the maximum number of saved studies (100). Determine the efficacy of TPEx combination in patients with head and neck cancer: Best Overall Response , progression-free survival and survival.

Compliance: Insufficient compliance for cetuximab is defined as a patient missing more than 2 consecutive infusions of cetuximab, even if the missed infusions are due to toxicity. Concurrent cetuximab and radiotherapy after docetaxel-cisplatin induction chemotherapy in stage III NSCLC: satellite--a phase II study from the Swedish Lung Cancer Study Group. Primary prophylactic administration of GCSF must be administered systematically after each cycle of chemotherapy. Dr. Li:I will emphasize the treatment of head/neck cancer should be data-driven, and I know they are not necessarily uniform because China has large geographical locations, which really make a difference. The views and opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of GLC and AGILE. The GORTEC trial evaluating the TPEx regimen (4 cycles of docetaxel–cisplatin-cetuximab followed by cetuximab maintenance) demonstrated good results (median OS 14 months, ORR 54%) with acceptable safety profile, excellent dose intensity, high rate of patients who started maintenance. Results: We enrolled 54 patients (median age, 58 years) between August 2013 and October 2015. 2011 Feb;71(2):166-72. doi: 10.1016/j.lungcan.2010.05.011. And in terms of burden of this disease, we need to consider that some of them need to be treated as soon as possible in order to have a symptomatic relief. I’m a medical oncologist specializing in head and neck cancer. Trial Registration: UMIN000009928. Cetuximab and taxane combinations have demonstrated promising activity in Head and Neck cancer. Global Learning Collaborative is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The primary endpoint of the QoL study is the global health status/quality of-life scale of the QLQ-C30 questionnaire, Quality-adjusted life-years (QALYs) based on Euroqol EQ-5D measurements. N Engl J Med. For all these patients with CPS less than 1, standard treatment is still EXTREME or TPEx. Patients who don't have any of these events are censored at the date of last follow-up. In addition the toxicity / efficacy profile also seems favourable as suggested by the excellent dose intensity achieved and the high rate of patients (78%) who were able to start maintenance therapy.