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Safety and efficacy of neoadjuvant chemotherapy with paclitaxel, carboplatin, and cetuximab for locally advanced head and neck squamous cell carcinoma

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Abstract

Background

As a substantial waiting time is usually required for radical surgery, safe and effective preoperative neoadjuvant chemotherapy (NAC) is desired for the treatment of locally advanced head and neck squamous cell carcinoma (HNSCC). However, the significance of NAC in advanced HNSCC is still unclear. This study aimed to assess the safety and efficacy of NAC using the paclitaxel, carboplatin, and cetuximab (PCE) regimen.

Methods

We retrospectively evaluated the background characteristics, incidence of adverse events, overall response rate (ORR), pathological response, recurrence-free survival (RFS), and overall survival (OS) in 26 patients. Patients receiving the PCE regimen were further divided into two groups based on the number of chemotherapy cycles (one cycle or more) and eligibility for cisplatin. Patients aged ≥ 75 years and those with an estimated glomerular filtration rate (eGFR) < 60 mL/min were classified as ineligible for cisplatin.

Results

The median age was 70 (27–81) years. The median eGFR at treatment initiation was 63.2 (41.1–89.7) mL/min. Fourteen (53.8%) patients were ineligible for cisplatin. Grade 3 or higher neutropenia was observed in 11 of 25 (42.3%) patients. No delay in or withdrawal from surgery was observed. The ORR was 65.4%. The 2-year RFS and OS were 61.5% and 76.7%, respectively. No significant differences in safety and efficacy between the number of chemotherapy cycles and cisplatin eligibility were observed.

Conclusion

NAC using the PCE regimen for patients with locally advanced HNSCC, including cisplatin-ineligible patients, has acceptable toxicity and favorable efficacy.

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Data availability

The original contributions presented in the study are included in the article; further inquiries can be directed to the corresponding author.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing services.

Funding

None declared.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757, Asahimachi-dori, Chuo-Ku, Niigata, 950-8510, Japan

    Ryoko Tanaka, Yushi Ueki, Shusuke Ohshima, Jo Omata, Yusuke Yokoyama, Takeshi Takahashi, Ryusuke Shodo, Kohei Ohtaki & Arata Horii

  2. Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan

    Ryoko Tanaka, Keisuke Yamazaki, Kohei Ohtaki & Takafumi Togashi

Authors
  1. Ryoko Tanaka
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  2. Yushi Ueki
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  3. Shusuke Ohshima
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  4. Jo Omata
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  5. Yusuke Yokoyama
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  6. Takeshi Takahashi
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  7. Ryusuke Shodo
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  8. Keisuke Yamazaki
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  9. Kohei Ohtaki
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  10. Takafumi Togashi
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  11. Arata Horii
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Contributions

Conception and design: R. Tanaka, Y. Ueki, T. Takahashi, and A. Horii. Data analysis and interpretation: R. Tanaka, Y. Ueki, S. Ohshima, Y. Yokoyama, T. Takahashi, R. Shodo, K. Yamazaki, K. Ohtaki, T. Togashi, and Y. Sato. Drafting of the manuscript: R. Tanaka, Y. Ueki, and A. Horii. Final approval of the version to be published: All authors. Y. Ueki has full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to Yushi Ueki.

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Conflict of interest

None declared.

Ethical approval

This trial was conducted in accordance with the Declaration of Helsinki, and all patients provided written informed consent before enrolling in the study. This study was approved by the Institutional Review Board of Niigata University Hospital (No. 2022-0157).

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Tanaka, R., Ueki, Y., Ohshima, S. et al. Safety and efficacy of neoadjuvant chemotherapy with paclitaxel, carboplatin, and cetuximab for locally advanced head and neck squamous cell carcinoma. Int J Clin Oncol (2024). https://doi.org/10.1007/s10147-024-02545-9

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  • DOI: https://doi.org/10.1007/s10147-024-02545-9

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