TITLE:
Nimotuzumab with Concurrent Chemoradiation in Inoperable Locally Advanced Squamous Cell Carcinoma of Head and Neck: An Indian Experience
AUTHORS:
Ankur Bahl, Komal Singh, Pragati Choudhary, A. K. Anand, Amal Roy Chaoudhoory, Harit Chaturvedi, Biswajyoti Hazarika, Dilip Pawar
KEYWORDS:
Epidermal Growth Factor Receptor, Chemoradiation, Locally Advanced Squamous Cell Carcinoma of Head and Neck, Humanised Monoclonal Antibody, Nimotuzumab
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.9 No.1,
January
31,
2018
ABSTRACT: Background: The prognosis of patients with Epidermal Growth
Factor Receptor (EGFR) overexpression in inoperable Locally Advanced Squamous
Cell Carcinoma of Head and Neck (LASCCHN) remains poor. Nimotuzumab is an Anti
EGFR humanized monoclonal antibody approved for treatment of LASCCHN, with
concurrent chemoradiation. Objective: To assess the efficacy and safety
of nimotuzumab with concurrent chemoradiation in inoperable LASCCHN patients. Methodology: This is a single-centre, single arm, retrospective study evaluating 35
patients with histologically confirmed inoperable LASCCHN (stages III-IV). The
patients were administered IV cisplatin 50 mg/m2 and IV nimotuzumab
200 mg for 6 - 7 weeks, along with radiotherapy of 6600 - 7000
cGy over 35 fractions. Patients were evaluated over response evaluation
criteria in solid tumors (RECIST) criteria 12 weeks after the last cycle of
chemotherapy. They were also followed up for overall survival and relapse free
survival. Results: The median duration of follow-up was
20 months. The most common site of cancer was oropharynx (68.6%). One patient
was lost to follow up. Objective Response Rate (ORR) was observed in 97% of the
patients with 17 patients (48.6%) achieving complete response (CR) and 17
patients (48.6%) achieving partial response (PR). The median overall survival
was 22.7 months (95% CI: 21.30, 34.27). The
median relapse free survival was 16.7 months (95% CI: 9.80, 24.50). Nimotuzumab
was safe and well tolerated with few mild, self-limiting adverse events. Conclusion: Nimotuzumab with chemoradiation is a safe and efficacious option in patients
with LASCCHN. Larger studies are needed to verify the same.