Cetuximab Plus Radiotherapy For Head And Neck Cancer

Cetuximab plus Radiotherapy for Head and Neck Cancer Rena Callahan Journal Club UCLA Internal Medicine Faculty Discussant: Steven Wong

Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck Bonner JA; Harari PM; Giralt J; Azarnia N; Shin DM; Cohen RB; Jones CU; Sur R; Raben D; Jassem J; Ove R; Kies MS; Baselga J; Youssoufian H; Amellal N; Rowinsky EK; Ang KK N Engl J Med. 2006 Feb 9 Volume 354(6):567-78.

Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Head and Neck Cancer (HNC) ,[object Object],[object Object],[object Object],[object Object],[object Object]

EGFR ,[object Object],[object Object],[object Object],[object Object]

Cetuximab ,[object Object],[object Object],[object Object],[object Object],[object Object]

Cetuximab Adverse Events ,[object Object],[object Object],[object Object]

Treatment – Locally Advanced HNC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Radiation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Radiation toxicity ,[object Object],[object Object],[object Object],[object Object]

Chemoradiation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Chemoradiation-Toxicity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Staging ,[object Object],[object Object],[object Object],AJCC 2002

Karnofsky Score ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Patients ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

424 Patients High dose radiotherapy High dose Radiotherapy + Cetuximab randomized N=213 N=211 Phase III, Randomized, Multicenter Study Design

Exclusion Criteria ,[object Object],[object Object],[object Object],[object Object]

Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

End Points ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Statistical Analyses ,[object Object],[object Object],[object Object],[object Object]

Results- Patients ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Locoregional Control HR=.68; (95% CI .52 to .89)

Overall Survival HR=.74; (95% CI .57 to .97)

Results- Risk reduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Results-safety ,[object Object],[object Object],[object Object],[object Object]

Study Limitations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

So, will this study change practice? ,[object Object],[object Object],[object Object]

Chemoradiation Studies Argiris A. Update on chemo radiotherapy for head and neck cancer . Curr Opin Oncol 2002;14:323-329.

Future Studies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Future studies ,[object Object],[object Object],[object Object],[object Object],[object Object]

Discussion- Cancer therapy trials ,[object Object],[object Object],[object Object]

References ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Cetuximab Plus Radiotherapy For Head And Neck Cancer

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Cetuximab Plus Radiotherapy For Head And Neck Cancer