FRIDAY, Oct. 26, 2018 — For patients with locoregionally advanced human papillomavirus (HPV)-related oropharynx cancer, radiation/cetuximab results in inferior overall and progression-free survival versus radiation/cisplatin, according to a study presented at the annual meeting of the American Society for Radiation Oncology, held Oct. 21 to 24 in San Antonio, Texas.

Andy Trotti, M.D., from the Moffitt Cancer Center and Research Institute in Tampa, Florida, and colleagues randomly assigned 805 eligible patients with locoregionally advanced HPV-related oropharynx cancer to 70 Gy accelerated (six fractions/week) with two cycles of cisplatin every three weeks versus the same radiation with weekly cetuximab.

The researchers found a hazard ratio of 1.45 for overall survival. The estimated five-year survival rates were 84.6 percent with cisplatin and 77.9 percent with cetuximab. For progression-free survival, the five-year estimates were 78.4 and 67.3 percent for cisplatin and cetuximab, respectively (hazard ratio, 1.72). For estimated five-year local-regional failure, the rates were 9.9 percent with cisplatin and 17.3 percent with cetuximab; distant metastases rates were 8.6 and 11.7 percent, respectively. Acute grade 3 to 4/grade 5 adverse events were 82/0.8 percent with cisplatin, and 77/1.3 percent with cetuximab. Anemia, hearing loss, nausea, vomiting, neutropenia, and kidney injury were more common with cisplatin, while rash was more common with cetuximab.

“We had hypothesized that survival with cetuximab might be very close (within 5 percent) to that of cisplatin,” Trotti said in a statement, “but that was not the case.”

The study was partially funded by Eli Lilly.

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Posted: October 2018

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