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Adding the EGFR antibody cetuximab to radiotherapy lengthened survival in locally advanced head and neck cancer by about 20 months without increasing the mucosal toxicity of radiotherapy, giving patients unfit for cisplatin an alternative.
Phase 3 trial of 424 patients with stage III to IV squamous cell carcinoma of the oropharynx, hypopharynx or larynx randomised to high-dose radiotherapy alone or with weekly cetuximab.
Median overall survival was 49.0 versus 29.3 months (hazard ratio 0.74) and locoregional control 24.4 versus 14.9 months; apart from acneiform rash and infusion reactions, toxicity was not increased. Later analyses suggested the benefit was concentrated in oropharyngeal cancer.
Cetuximab-radiotherapy is the standard for patients who cannot receive cisplatin; head-to-head trials in HPV-positive disease (RTOG 1016, De-ESCALaTE) later showed it inferior to cisplatin where cisplatin is possible.
Shares Hypopharyngeal cancer, HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), Cetuximab.
Shares Lip cancer, HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), New England Journal of Medicine.
Shares HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), New England Journal of Medicine.
Shares HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), New England Journal of Medicine.
Shares HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), New England Journal of Medicine.
Shares Cetuximab, New England Journal of Medicine.
Shares Lip cancer, Hypopharyngeal cancer, HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer).