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Cisplatin with radiation benefited HPV–, p16–positive status in locally advanced head and neck cancer

Issue: November 25, 2010

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52nd ASTRO Annual Meeting

SAN DIEGO — Cisplatin and radiation was associated with improved outcomes among patients with locally advanced head and neck cancer as well as HPV– or p16–positive status, according to data from a subset analysis.

Findings from a previous study demonstrated that treatment with cisplatin and radiation for locally advanced head and neck cancer was superior to treatment with cetuximab (Erbitux, ImClone) and radiation.

From March 1, 2006, to April 1, 2008, researchers retrospectively identified patients who received definitive treatment for locally advanced head and neck cancer with either cisplatin and radiation (planned cumulative dose: 100 mg/m² every 3 weeks for three cycles) or cetuximab and radiation (400 mg/m² load; 250 mg/m² weekly). Patients in the cisplatin group were younger, had better renal function and were more likely to be treated at a regional network site.

HPV status was positive in 42% of patients in the cisplatin group and 35% of those in the cetuximab group (P=.58). Eighty-three percent of patients in the cisplatin group and 74% in the cetuximab group were p16–positive (P=.62).

The median follow-up was 32 months. The 30-month locoregional failure rates were 11% in the cisplatin group vs. 32% in the cetuximab group (P=.032). The 30-month DFS rate was 84% with cisplatin and 49% with cetuximab (P=.0017).

The 30-month OS rate was 88% with cisplatin and 78% with cetuximab (P=.22). Patients with HPV–negative status demonstrated nonstatistically significant elevated locoregional failure (HR=1.78; 95% CI, 0.48-6.57), decreased DFS (HR=1.32; 95% CI, 0.50-3.53) and OS (HR=0.71; 95% CI, 0.45-6.48).

P16–negative patients demonstrated nonstatistically significant elevated locoregional failure (HR=1.69; 95% CI, 0.45-6.36), reduced DFS (HR=2.25; 95% CI, 0.83-6.09) and OS (HR=2.81; 95% CI, 0.79-9.99).

In multivariate analysis, treatment with cisplatin still predicted reduced locoregional failure (HR=0.14; 95% CI, 0.04-0.53) and improved DFS (HR=0.18; 95% CI, 0.06-0.50). – by Christen Cona

For more information:

• Koutcher L. Abstract #133. Presented at: 52nd ASTRO Annual Meeting; Oct. 31-Nov. 4, 2010; San Diego.

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