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Current treatment options for recurrent/metastatic head and neck cancer: a post-ASCO 2011 update and review of last year’s literature

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Abstract

The majority of patients with a squamous cell carcinoma of the head and neck present with locally advanced tumors. The first-line treatment of locally advanced tumor stages consists of a combined modality management. Despite these aggressive protocols, many patients develop locoregional recurrences or metastasis and place particularly high demands on the interdisciplinary treatment team. Treatment with a curative intent must be differentiated from a palliative one. In addition to prior treatment, resectability, age and performance status, patient wishes must be taken into consideration in treatment planning, especially considering that most therapies offer little to no overall survival benefit. Salvage surgery, chemo- and target therapies, and reirradiation are head and neck surgeon’s and radiooncologist’s weapons in the fight against these strong opponents. This review focuses on publications and meeting news from last year and reviews the current status of the clinical application of each treatment modality in recurrent or metastatic head and neck cancer.

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References

  1. McDonald MW, Lawson J, Garg MK, Quon H, Ridge JA, Saba N, Salama JK, Smith RV, Yeung AR, Yom SS, Beitler JJ (2011) ACR appropriateness criteria(R) retreatment of recurrent head and neck cancer after prior definitive radiation expert panel on radiation oncology—head and neck cancer. Int J Radiat Oncol Biol Phys 80(5):1292–1298. doi:10.1016/j.ijrobp.2011.02.014

    Article  PubMed  Google Scholar 

  2. Choe KS, Haraf DJ, Solanki A, Cohen EE, Seiwert TY, Stenson KM, Blair EA, Portugal L, Villaflor VM, Witt ME, Vokes EE, Salama JK (2011) Prior chemoradiotherapy adversely impacts outcomes of recurrent and second primary head and neck cancer treated with concurrent chemotherapy and reirradiation. Cancer. doi:10.1002/cncr.26084

    PubMed  Google Scholar 

  3. Harrison LB, Mourad WF, Perksy M, Urken M, Jacobson A, Culliney B, Tran T, Schantz SP, Costantino P, Hu K (2011) High dose rate intraoperative radiation therapy for recurrent head and neck cancer: the importance of in-field control on survival. ASCO Meet Abstr 29(15 suppl):5593

    Google Scholar 

  4. Perry DJ, Chan K, Wolden S, Zelefsky MJ, Chiu J, Cohen G, Zaider M, Kraus D, Shah J, Lee N (2010) High-dose-rate intraoperative radiation therapy for recurrent head-and-neck cancer. Int J Radiat Oncol Biol Phys 76(4):1140–1146. doi:10.1016/j.ijrobp.2009.03.025

    Article  PubMed  Google Scholar 

  5. Janot F, de Raucourt D, Benhamou E, Ferron C, Dolivet G, Bensadoun RJ, Hamoir M, Gery B, Julieron M, Castaing M, Bardet E, Gregoire V, Bourhis J (2008) Randomized trial of postoperative reirradiation combined with chemotherapy after salvage surgery compared with salvage surgery alone in head and neck carcinoma. J Clin Oncol 26(34):5518–5523. doi:10.1200/JCO.2007.15.0102

    Article  PubMed  CAS  Google Scholar 

  6. Janot F, Thariat J, Daly-Schweitzer N (2011) Reirradiation in head and neck cancers. Anticancer Drugs 22(7):634–638. doi:10.1097/CAD.0b013e32834129b3

    Article  PubMed  CAS  Google Scholar 

  7. Kumar P, Sinha UK (2011) Comprehensive volume hyperfractionated (HFx) re-irradiation (Re-RT) of recurrent head and neck (H/N) cancer is feasible. ASCO Meet Abstr 29(15_suppl):5551

    Google Scholar 

  8. Kao J, Genden EM, Chen CT, Rivera M, Tong CC, Misiukiewicz K, Gupta V, Gurudutt V, Teng M, Packer SH (2011) Phase 1 trial of concurrent erlotinib, celecoxib, and reirradiation for recurrent head and neck cancer. Cancer 117(14):3173–3181. doi:10.1002/cncr.25786

    Article  PubMed  CAS  Google Scholar 

  9. Rusthoven KE, Feigenberg SJ, Raben D, Kane M, Song JI, Nicolaou N, Mehra R, Burtness B, Ridge J, Swing R, Lango M, Cohen R, Jimeno A, Chen C (2010) Initial results of a Phase I dose-escalation trial of concurrent and maintenance erlotinib and reirradiation for recurrent and new primary head-and-neck cancer. Int J Radiat Oncol Biol Phys 78(4):1020–1025. doi:10.1016/j.ijrobp.2009.09.003

    Article  PubMed  CAS  Google Scholar 

  10. Zwicker F, Roeder F, Thieke C, Timke C, Munter MW, Huber PE, Debus J (2011) IMRT reirradiation with concurrent cetuximab immunotherapy in recurrent head and neck cancer. Strahlenther Onkol 187(1):32–38. doi:10.1007/s00066-010-2149-7

    Article  PubMed  Google Scholar 

  11. Zwicker F, Roeder F, Hauswald H, Thieke C, Timke C, Schlegel W, Debus J, Munter MW, Huber PE (2011) Reirradiation with intensity-modulated radiotherapy in recurrent head and neck cancer. Head Neck. doi:10.1002/hed.21663

    PubMed  Google Scholar 

  12. McDonald MW, Moore MG, Johnstone PA (2011) Risk of carotid blowout after reirradiation of the head and neck: a systematic review. Int J Radiat Oncol Biol Phys. doi:10.1016/j.ijrobp.2010.08.029

    Google Scholar 

  13. Vermorken JB, Specenier P (2010) Optimal treatment for recurrent/metastatic head and neck cancer. Ann Oncol 21(Suppl 7):vii252–vii261. doi:10.1093/annonc/mdq453

    Article  PubMed  Google Scholar 

  14. Colevas AD (2006) Chemotherapy options for patients with metastatic or recurrent squamous cell carcinoma of the head and neck. J Clin Oncol 24(17):2644–2652. doi:10.1200/JCO.2005.05.3348

    Article  PubMed  CAS  Google Scholar 

  15. Vermorken JB, Mesia R, Rivera F, Remenar E, Kawecki A, Rottey S, Erfan J, Zabolotnyy D, Kienzer HR, Cupissol D, Peyrade F, Benasso M, Vynnychenko I, De Raucourt D, Bokemeyer C, Schueler A, Amellal N, Hitt R (2008) Platinum-based chemotherapy plus cetuximab in head and neck cancer. N Engl J Med 359(11):1116–1127. doi:10.1056/NEJMoa0802656

    Article  PubMed  CAS  Google Scholar 

  16. Urba SG, Forastiere AA (1989) Systemic therapy of head and neck cancer: most effective agents, areas of promise. Oncology (Williston Park) 3(4):79–88; discussion 88, 90, 97–78

    Google Scholar 

  17. Forastiere AA, Metch B, Schuller DE, Ensley JF, Hutchins LF, Triozzi P, Kish JA, McClure S, VonFeldt E, Williamson SK et al (1992) Randomized comparison of cisplatin plus fluorouracil and carboplatin plus fluorouracil versus methotrexate in advanced squamous-cell carcinoma of the head and neck: a Southwest Oncology Group study. J Clin Oncol 10(8):1245–1251

    PubMed  CAS  Google Scholar 

  18. Won YW, Park YH, Ahn MJ, Do IG, Ko YH, Park K (2011) A phase II study of combination chemotherapy with capecitabine and cisplatin in patients with metastatic or recurrent squamous cell carcinoma of the head and neck. Ann Oncol 22(2):417–423. doi:10.1093/annonc/mdq355

    Article  PubMed  Google Scholar 

  19. Boku N, Yamamoto S, Fukuda H, Shirao K, Doi T, Sawaki A, Koizumi W, Saito H, Yamaguchi K, Takiuchi H, Nasu J, Ohtsu A (2009) Fluorouracil versus combination of irinotecan plus cisplatin versus S-1 in metastatic gastric cancer: a randomised phase 3 study. Lancet Oncol 10(11):1063–1069. doi:10.1016/S1470-2045(09)70259-1

    Article  PubMed  CAS  Google Scholar 

  20. Ajani JA, Rodriguez W, Bodoky G, Moiseyenko V, Lichinitser M, Gorbunova V, Vynnychenko I, Garin A, Lang I, Falcon S (2010) Multicenter phase III comparison of cisplatin/S-1 with cisplatin/infusional fluorouracil in advanced gastric or gastroesophageal adenocarcinoma study: the FLAGS trial. J Clin Oncol 28(9):1547–1553. doi:10.1200/JCO.2009.25.4706

    Article  PubMed  CAS  Google Scholar 

  21. Tahara M, Araki K, Okano S, Kiyota N, Fuse N, Minashi K, Yoshino T, Doi T, Zenda S, Kawashima M, Ogino T, Hayashi R, Minami H, Ohtsu A (2011) Phase I trial of combination chemotherapy with docetaxel, cisplatin and S-1 (TPS) in patients with locally advanced or recurrent/metastatic head and neck cancer. Ann Oncol 22(1):175–180. doi:10.1093/annonc/mdq298

    Article  PubMed  CAS  Google Scholar 

  22. Vermorken JB, Remenar E, van Herpen C, Gorlia T, Mesia R, Degardin M, Stewart JS, Jelic S, Betka J, Preiss JH, van den Weyngaert D, Awada A, Cupissol D, Kienzer HR, Rey A, Desaunois I, Bernier J, Lefebvre JL (2007) Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer. N Engl J Med 357(17):1695–1704. doi:10.1056/NEJMoa071028

    Article  PubMed  CAS  Google Scholar 

  23. Lorch JH, Goloubeva O, Haddad RI, Cullen K, Sarlis N, Tishler R, Tan M, Fasciano J, Sammartino DE, Posner MR (2011) Induction chemotherapy with cisplatin and fluorouracil alone or in combination with docetaxel in locally advanced squamous-cell cancer of the head and neck: long-term results of the TAX 324 randomised phase 3 trial. Lancet Oncol 12(2):153–159. doi:10.1016/S1470-2045(10)70279-5

    Article  PubMed  CAS  Google Scholar 

  24. Posner MR, Hershock DM, Blajman CR, Mickiewicz E, Winquist E, Gorbounova V, Tjulandin S, Shin DM, Cullen K, Ervin TJ, Murphy BA, Raez LE, Cohen RB, Spaulding M, Tishler RB, Roth B, Viroglio Rdel C, Venkatesan V, Romanov I, Agarwala S, Harter KW, Dugan M, Cmelak A, Markoe AM, Read PW, Steinbrenner L, Colevas AD, Norris CM Jr, Haddad RI (2007) Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med 357(17):1705–1715. doi:10.1056/NEJMoa070956

    Article  PubMed  CAS  Google Scholar 

  25. Gibson MK, Li Y, Murphy B, Hussain MH, DeConti RC, Ensley J, Forastiere AA (2005) Randomized phase III evaluation of cisplatin plus fluorouracil versus cisplatin plus paclitaxel in advanced head and neck cancer (E1395): an intergroup trial of the Eastern Cooperative Oncology Group. J Clin Oncol 23(15):3562–3567. doi:10.1200/JCO.2005.01.057

    Article  PubMed  CAS  Google Scholar 

  26. Suzuki K (2011) Docetaxel and cisplatin therapy and survival outcomes with patients with relapsed and refractory squamous cancer. ASCO Meet Abstr 29(15 suppl):e16005

    Google Scholar 

  27. Ang KK, Berkey BA, Tu X, Zhang HZ, Katz R, Hammond EH, Fu KK, Milas L (2002) Impact of epidermal growth factor receptor expression on survival and pattern of relapse in patients with advanced head and neck carcinoma. Cancer Res 62(24):7350–7356

    PubMed  CAS  Google Scholar 

  28. Chung CH, Ely K, McGavran L, Varella-Garcia M, Parker J, Parker N, Jarrett C, Carter J, Murphy BA, Netterville J, Burkey BB, Sinard R, Cmelak A, Levy S, Yarbrough WG, Slebos RJ, Hirsch FR (2006) Increased epidermal growth factor receptor gene copy number is associated with poor prognosis in head and neck squamous cell carcinomas. J Clin Oncol 24(25):4170–4176. doi:10.1200/JCO.2006.07.2587

    Article  PubMed  CAS  Google Scholar 

  29. Licitra L, Mesia R, Rivera F, Remenar E, Hitt R, Erfan J, Rottey S, Kawecki A, Zabolotnyy D, Benasso M, Storkel S, Senger S, Stroh C, Vermorken JB (2011) Evaluation of EGFR gene copy number as a predictive biomarker for the efficacy of cetuximab in combination with chemotherapy in the first-line treatment of recurrent and/or metastatic squamous cell carcinoma of the head and neck: EXTREME study. Ann Oncol 22(5):1078–1087. doi:10.1093/annonc/mdq588

    Article  PubMed  CAS  Google Scholar 

  30. Greenhalgh J, Bagust A, Boland A, Fleeman N, McLeod C, Dundar Y, Proudlove C, Shaw R (2009) Cetuximab for the treatment of recurrent and/or metastatic squamous cell carcinoma of the head and neck. Health Technol Assess 13(Suppl 3):49–54. doi:10.3310/hta13suppl3/08

    PubMed  Google Scholar 

  31. Perez CA, Song H, Raez LE, Agulnik M, Grushko TA, Dekker A, Stenson K, Blair EA, Olopade OI, Seiwert TY, Vokes EE, Cohen EE (2011) Phase II study of gefitinib adaptive dose escalation to skin toxicity in recurrent and/or metastatic squamous cell carcinoma of the head and neck. ASCO Meet Abstr 29(15_suppl):5517

    Google Scholar 

  32. Brooks HD, Glisson BS, Bekele BN, Ginsberg LE, El-Naggar A, Culotta KS, Takebe N, Wright J, Tran HT, Papadimitrakopoulou VA (2011) Phase 2 study of dasatinib in the treatment of head and neck squamous cell carcinoma. Cancer 117(10):2112–2119. doi:10.1002/cncr.25769

    Article  PubMed  CAS  Google Scholar 

  33. Fury MG, Baxi S, Shen R, Kelly KW, Lipson BL, Carlson D, Stambuk H, Haque S, Pfister DG (2011) Phase II study of saracatinib (AZD0530) for patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC). Anticancer Res 31(1):249–253

    PubMed  CAS  Google Scholar 

  34. Siu LL, Hotte SJ, Laurie SA, Singh S, Winquist E, Chia SKL, Chen EX, Chan KK, Wang T, Taylor I, Ruiz-Garcia A, Mormont C, Soulieres D (2011) Phase II trial of the irreversible oral pan-human EGF receptor (HER) inhibitor PF-00299804 (PF) as first-line treatment in recurrent and/or metastatic (RM) squamous cell carcinoma of the head and neck (SCCHN). ASCO Meet Abstr 29(15 suppl):5561

    Google Scholar 

  35. Fountzilas G, Fragkoulidi A, Kalogera-Fountzila A, Nikolaidou M, Bobos M, Calderaro J, Andreiuolo F, Marselos M (2010) A phase II study of sunitinib in patients with recurrent and/or metastatic non-nasopharyngeal head and neck cancer. Cancer Chemother Pharmacol 65(4):649–660. doi:10.1007/s00280-009-1070-1

    Article  PubMed  CAS  Google Scholar 

  36. Machiels JP, Henry S, Zanetta S, Kaminsky MC, Michoux N, Rommel D, Schmitz S, Bompas E, Dillies AF, Faivre S, Moxhon A, Duprez T, Guigay J (2010) Phase II study of sunitinib in recurrent or metastatic squamous cell carcinoma of the head and neck: GORTEC 2006–01. J Clin Oncol 28(1):21–28. doi:10.1200/JCO.2009.23.8584

    Article  PubMed  CAS  Google Scholar 

  37. Choong NW, Kozloff M, Taber D, Hu HS, Wade J III, Ivy P, Karrison TG, Dekker A, Vokes EE, Cohen EE (2010) Phase II study of sunitinib malate in head and neck squamous cell carcinoma. Invest New Drugs 28(5):677–683. doi:10.1007/s10637-009-9296-7

    Article  PubMed  CAS  Google Scholar 

  38. Vermorken JB, Guigay J, Mesia R, Trigo JM, Keilholz U, Kerber A, Bethe U, Picard M, Brummendorf TH (2011) Phase I/II trial of cilengitide with cetuximab, cisplatin and 5-fluorouracil in recurrent and/or metastatic squamous cell cancer of the head and neck: findings of the phase I part. Br J Cancer 104(11):1691–1696. doi:10.1038/bjc.2011.152

    Article  PubMed  CAS  Google Scholar 

  39. Machiels JP, Subramanian S, Ruzsa A, Repassy G, Lifirenko I, Flygare A, Sorensen P, Nielsen T, Lisby S, Clement PM (2011) Zalutumumab plus best supportive care versus best supportive care alone in patients with recurrent or metastatic squamous-cell carcinoma of the head and neck after failure of platinum-based chemotherapy: an open-label, randomised phase 3 trial. Lancet Oncol 12(4):333–343. doi:10.1016/S1470-2045(11)70034-1

    Article  PubMed  CAS  Google Scholar 

  40. Argiris A, Kotsakis AP, Kim S, Worden FP, Savvides P, Gibson MK, Blumenschein GR, Chen HX, Grandis JR, Kies MS (2011) Phase II trial of cetuximab (C) and bevacizumab (B) in recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN): final results. ASCO Meet Abstr 29(15 suppl):5564

    Google Scholar 

  41. Gibson MK, Kies M, Kim S, Savvides P, Kotsakis A, Blumenschein G, Worden F, Chen H, Grandis J, Argiris A (2009) Cetuximab (C) and bevacizumab (B) in patients with recurrent or metastatic head and neck squamous cell carcinoma: an updated report. ASCO Meet Abstr 27(15S):6049

    Google Scholar 

  42. Rampias T, Giagini A, Florou K, Gouveris P, Vaja E, Haralambakis N, Katsaounis P, Pectasides DG, Economopoulos T, Psyrri A (2011) H-RAS and PIK3CA mutations and response to cetuximab in head and neck squamous cell carcinoma (HNSCC). ASCO Meet Abstr 29(15 suppl):5513

    Google Scholar 

  43. Guigay J, Fayette J, Dillies A, Sire C, Kerger JN, Tennevet I, Machiels JH, Zanetta S, Pointreau Y, Bozec Le Moal L, Brugel Ribere L, Henry S, Temam S, GORTEC (2011) Cetuximab, docetaxel, and cisplatin (TPEx) as first-line treatment in patients with recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN): first results of phase II trial GORTEC 2008-03. ASCO Meet Abstr 29 (15 suppl):5567

  44. Shin DM, Donato NJ, Perez-Soler R, Shin HJ, Wu JY, Zhang P, Lawhorn K, Khuri FR, Glisson BS, Myers J, Clayman G, Pfister D, Falcey J, Waksal H, Mendelsohn J, Hong WK (2001) Epidermal growth factor receptor-targeted therapy with C225 and cisplatin in patients with head and neck cancer. Clin Cancer Res 7(5):1204–1213

    PubMed  CAS  Google Scholar 

  45. Fury MG, Sherman EJ, Lisa DM, Agarwal N, Algazy KM, Brockstein B, Langer CJ, Lim D, Mehra R, Rajan SK, Jafri N, Korte S, Lipson B, Yunus F, Tanvetyanon T, Smith-Marrone S, Ng KK, Xiao H, Haque S, Pfister DG (2011) A randomized phase II study of cetuximab (C) every 2 weeks at either 500 or 750 mg/m2 for patients (Pts) with recurrent or metastatic (R/M) head and neck squamous cell cancer (HNSCC). ASCO Meet Abstr 29(15 suppl):5563

    Google Scholar 

  46. Wolf TG, Fee WE, Dolan RW, Moyer JS, Kaplan MJ, Spring PM, Suen J, Kenady DE, Newman JG, Carroll WR, Gillespie MB, Freeman SM, Baltzer L, Kirkley TD, Bandwein HJ, Hadden JW (2011) Novel neoadjuvant immunotherapy regimen safety and survival in head and neck squamous cell cancer. Head Neck 33(12):1666–1674

    Article  PubMed  Google Scholar 

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Correspondence to T. Kurzweg.

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T. Kurzweg and N. Möckelmann contributed equally to this work and share the first authorship.

Appendix

Appendix

Box 1 Items to be assessed when taking the patient history in recurrent/metastatic situations to prepare the interdisciplinary decision [1]

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Kurzweg, T., Möckelmann, N., Laban, S. et al. Current treatment options for recurrent/metastatic head and neck cancer: a post-ASCO 2011 update and review of last year’s literature. Eur Arch Otorhinolaryngol 269, 2157–2167 (2012). https://doi.org/10.1007/s00405-012-1998-3

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