Cetuximab and platinum-based chemoradio- or chemotherapy of patients with epidermal growth factor receptor expressing adenoid cystic carcinoma: a phase II trial

• Published in: British journal of cancer Vol. 109; no. 5; pp. 1117 - 1122
• Main Authors: Hitre, E, Budai, B, Takácsi-Nagy, Z, Rubovszky, G, Tóth, E, Remenár, É, Polgár, C, Láng, I
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 03.09.2013; Nature Publishing Group
• Subjects: 5-Fluorouracil; 692/699/67; 692/699/67/1059/485; 692/699/67/1059/99; Adenoid; Adult; Aged; Antibodies, Monoclonal, Humanized - adverse effects; Antibodies, Monoclonal, Humanized - therapeutic use; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cancer Research; Cancer therapies; Carcinoma; Carcinoma, Adenoid Cystic - drug therapy; Carcinoma, Adenoid Cystic - mortality; Carcinoma, Adenoid Cystic - radiotherapy; Cetuximab; Chemotherapy; Cisplatin; Cisplatin - therapeutic use; Clinical Study; Combined Modality Therapy - adverse effects; Dermatitis; Disease-Free Survival; Drug Resistance; Drug therapy; Epidemiology; Epidermal growth factor; Epidermal growth factor receptors; Exocrine glands; Female; Fluorouracil - therapeutic use; Humans; Male; Medical sciences; Metastases; Metastasis; Middle Aged; Molecular Medicine; Monoclonal antibodies; Mucositis; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Oncology; Platinum; Radiation therapy; Receptor, Epidermal Growth Factor - metabolism; Response rates; Survival; Targeted cancer therapy; Toxicity; Tumors; Young Adult; radiotherapy; cetuximab; adenoid cystic carcinoma; chemotherapy; Antineoplastic agent; Human; Cystic adenoid carcinoma; Monoclonal antibody; Malignant tumor; Radiotherapy; Epidermal growth factor receptor; Immunomodulator; Chemotherapy; Growth factor receptor; Cancerology; Treatment; Platinum; Phase II trial; Cetuximab; Cancer
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/bjc.2013.468

Background: Epidermal growth factor receptor (EGFR) is highly expressed in adenoid cystic carcinoma (ACC). The efficacy and toxicity of cetuximab with concomitant platinum-based chemoradio- or chemotherapy in patients with locally advanced or metastatic ACC, respectively, was evaluated. Methods: Eligible patients (9 with locally advanced tumour and 12 with metastases) had positive tumour EGFR expression. The cetuximab loading dose (400 mg m −2 ) was followed by 250 mg m −2 per week. Locally advanced tumours were irradiated (mean dose 65 Gy) and treated with concomitant cisplatin (75 mg m −2 , intravenously). Patients with metastases received concomitant cisplatin and 5-fluorouracil (4 × 1000 mg m −2 ). Results: For patients with locally advanced disease (median follow-up: 52 months), the median progression-free survival (PFS) was 64 months and the 2-year overall survival (OS) rate was 100%. For patients with metastases (median follow-up: 72 months), the median PFS and OS were 13 and 24 months, respectively. In both groups the objective response rate was >40%. Skin rash, in-field dermatitis, mucositis and vomiting were the most frequent grade 3/4 adverse events. Conclusion: In this single-arm study, the efficacy of cetuximab plus chemoradio- or chemotherapy appeared favourable as compared with historical controls. All side effects were manageable and did not hamper the treatment.