• 8/24/2006
  • Chicago, IL
  • John Otrompke
  • www.docguide.com

An investigational chemotherapeutic agent under research in the treatment of gastrointestinal carcinoma may also have utility as part of a combination regimen for head and neck cancer, according to a poster presented here at the 2006 annual meeting of the American Head and Neck Society (AHNS).

“These patients are heavily pretreated, and they’re ill. Often it is not possible to give them cisplatin, because it is nephrotoxic and cardiotoxic. But we can give them oxaliplatin even if they have heart failure,” said study presenter Jan Raguse, MD, oral and maxillofacial surgeon, Charite Campus, Berlin, Germany.

Between 2002 and 2004, Dr. Raguse and colleagues enrolled 36 patients with recurrent and/or metastatic disease and treated them with the combined regimen. The overall response was 60.6% (21.2% complete responders and 39.4% partial responders), and the 1-year survival rate was 43.2%. Twenty-four percent of patients were alive after 2 years.

Of those enrolled, 14 had previously been treated with surgery and radiation, and 22 had been treated with radiation and chemotherapy, Dr. Raguse said. The median age of patients was 59 years, and overall survival was nearly 1 year in 60% of the study’s patients, he said. Median survival for those receiving conventional palliative chemotherapy is usually in the 4-to6-month range, the poster said.

Another advantage of the oxaliplatin regimen was that the treatment was administered over a 24-hour period, compared with the corresponding cisplatin regimen, which often occurs over the course of a week.

However, drawbacks of the oxaliplatin regimen included paresthesias and other adverse effects. All patients who received more than 3 cycles of oxaliplatin developed paresthesias, and dose reduction was necessary in 2 patients due to grade-3 diarrhea, according to the abstract.

Locoregional recurrence occurred in 60% of patients, with distant metastases in 25%.

“Oxaliplatin has nearly the same action as cisplatin, which has been used to treat these patients for years, but it is not nephrotoxic,” Dr. Raguse said.

Source:
Presentation title: Oxaliplatin, Folic Acid, and 5-Fluorouracil [OFF] in Recurrent Advanced Head and Neck Cancer: a Phase II Trial. Poster 016 – AHNS 2006