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Phase 2 trial of oxaliplatin and pemetrexed as an induction regimen in locally advanced head and neck cancer
Version of Record online: 15 JUL 2011
Copyright © 2011 American Cancer Society
Volume 118, Issue 4, pages 1007–1013, 15 February 2012
How to Cite
Gilbert, J., Murphy, B., Dietrich, M. S., Henry, E., Jordan, R., Counsell, A., Wirth, P., Yarbrough, W. G., Slebos, R. J. and Chung, C. H. (2012), Phase 2 trial of oxaliplatin and pemetrexed as an induction regimen in locally advanced head and neck cancer. Cancer, 118: 1007–1013. doi: 10.1002/cncr.26364
- Issue online: 3 FEB 2012
- Version of Record online: 15 JUL 2011
- Manuscript Accepted: 5 MAY 2011
- Manuscript Revised: 3 MAY 2011
- Manuscript Received: 28 FEB 2011
- head and neck cancer;
- phase 2
This phase 2 trial evaluated the tolerability and clinical efficacy of the combination of oxaliplatin and pemetrexed as an induction chemotherapy regimen in locally advanced head and neck squamous cell carcinoma (HNSCC).
Forty-two patients were enrolled in the study. Patients received pemetrexed 300 mg/m2 intravenously (IV) and oxaliplatin 85 mg/m2 IV every 14 days for a total of 4 cycles. A subset of patients consented to correlative studies including tumor tissue for human papillomavirus (HPV) detection and expression of DNA repair genes that may be predictive of response or resistance to oxaliplatin or pemetrexed.
Response data were available for 40 patients. Eighteen had a partial response, and 1 had a complete response, for a response rate of 47.5%. Patients with HPV+ disease demonstrated superior response rates, progression-free survival, and overall survival. The regimen was well tolerated, with predominantly grade 1 or 2 alanine aminotransferase/aspartate aminotransferase elevation. One patient had grade 5 toxicity with neutropenia and sepsis. The authors did not identify genes predictive of response or toxicity, although HPV+ tumors demonstrated a unique gene expression signature.
Although the response rate of oxaliplatin and pemetrexed proved less than anticipated, the combination remains an active induction regimen in HNSCC. This regimen should be evaluated further in combination with targeted agents, such as cetuximab, especially in the HPV+ patient population. Cancer 2012;. © 2011 American Cancer Society.