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A phase II study of intra-arterial cisplatin with concurrent radiation and erlotinib for locally advanced head and neck cancer
Authors:Krishna Rao  Sini Kalapurakal  Pratima Chalasani  Kathy Robinson  James Malone  Cathy Clausen  Ohad Ronen  Muthuswamy Dhiwakar  Bruce Shevlin  K. Thomas Robbins
Affiliation:1. Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL, USA
2. Division of Hematology and Oncology, Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL, USA
3. Department of Medical Microbiology, Southern Illinois University School of Medicine, Springfield, IL, USA
4. Simmons Cancer Institute, Southern Illinois University School of Medicine, 315 W. Carpenter St., PO Box 19678, Springfield, IL, 62794-9678, USA
5. Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA
6. St. John’s Hospital Department of Radiation Oncology, Springfield, IL, USA
7. Otolaryngology—Head and Neck Surgery Department, Carmel Medical Center, Haifa, Israel
8. KMCH & KMCH Comprehensive Cancer Center, Coimbatore, India
Abstract:

Background

Based on the convenient oral dosing of erlotinib and the promising results of biologic therapy, we undertook a phase II study with 21 patients with locally advanced (T3–4) lesions combining radiation with intra-arterial (IA) cisplatin and oral daily erlotinib for a 7-week therapy.

Methods

Treatment for the primary tumor and upper neck was given to a total dose of 70 Gy. Chemotherapy with IA cisplatin (150 mg/m2) was given on days 1, 8, 15, and 22 concurrently with radiotherapy. During the 7-week treatment period, patients were given erlotinib 150 mg/day.

Results

Overall survival is 63 %, and the relapse/persistent disease rate stands at 36.8 %. A total of 15.2 % of serious adverse event was considered related to erlotinib.

Conclusion

Our study and several others now demonstrate the feasibility of combining anti-epidermal growth factor receptor (EGFR) therapy with chemoradiation, hint at improved survival outcomes with reduced distant metastatic rates, and suggest that maintenance therapy with anti-EGFR agent may be beneficial.
Keywords:
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