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The Bonner trial was the first to show that a targeted antibody improves survival when added to radiotherapy: cetuximab with radiotherapy lengthened survival in head and neck cancer, and became the option for patients who cannot have cisplatin.
Bonner and colleagues randomised 424 patients with stage III or IV squamous cell carcinoma of the oropharynx, hypopharynx or larynx to high-dose radiotherapy alone or with weekly cetuximab. Median overall survival was 49.0 months with cetuximab versus 29.3 months (hazard ratio 0.74), and locoregional control improved, with an acneiform rash but no increase in mucositis (New England Journal of Medicine 2006). Later trials (RTOG 1016, De-ESCALaTE) showed cetuximab is inferior to cisplatin in HPV-positive disease, so its role is in cisplatin-unfit patients.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
424 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Locoregional control (primary) and overall survivalprimary | Radiotherapy plus cetuximab | 211 | 49 months | - | - | - |
| Radiotherapy alone | 213 | 29.3 months |
Shares Hypopharyngeal cancer, Laryngeal and hypopharyngeal cancer, Radiosensitisers, Head and neck squamous cell carcinoma and the tag radiation-wave4.
Shares Oropharyngeal cancer (tonsil and base of tongue), Cetuximab, Head and neck squamous cell carcinoma, IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares Oropharyngeal cancer (tonsil and base of tongue), Cetuximab, Head and neck squamous cell carcinoma, IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares Radiosensitisers, IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares IMRT / IGRT (modern external beam) and the tag radiation-wave4.