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Cetuximab Plus Radiotherapy For Head And Neck Cancer

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Cetuximab plus Radiotherapy for Head and Neck Cancer Rena Callahan Journal Club UCLA Internal Medicine Faculty Discussant: Steven Wong
Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck Bonner JA; Harari PM; Giralt J; Azarnia N; Shin DM; Cohen RB; Jones CU; Sur R; Raben D; Jassem J; Ove R; Kies MS; Baselga J; Youssoufian H; Amellal N; Rowinsky EK; Ang KK N Engl J Med. 2006 Feb 9 Volume 354(6):567-78.
Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Head and Neck Cancer (HNC) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Head and Neck Anatomy
EGFR ,[object Object],[object Object],[object Object],[object Object]
EGFR                                                                                            
Cetuximab ,[object Object],[object Object],[object Object],[object Object],[object Object]
Cetuximab Adverse Events ,[object Object],[object Object],[object Object]
Cetuximab Rash
The Approval of Cetuximab
Treatment – Locally Advanced HNC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Radiation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Radiation toxicity ,[object Object],[object Object],[object Object],[object Object]
Chemoradiation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chemoradiation-Toxicity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Staging ,[object Object],[object Object],[object Object],AJCC 2002
Karnofsky Score ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Patients ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
424 Patients High dose radiotherapy High dose Radiotherapy + Cetuximab randomized N=213 N=211 Phase III, Randomized, Multicenter Study Design
Exclusion Criteria ,[object Object],[object Object],[object Object],[object Object]
Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
End Points ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Statistical Analyses ,[object Object],[object Object],[object Object],[object Object]
Patient Characteristics
Results- Patients ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Results-efficacy
Locoregional Control HR=.68; (95% CI .52 to .89)
Overall Survival HR=.74; (95% CI .57 to .97)
Results- Risk reduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Results-safety ,[object Object],[object Object],[object Object],[object Object]
Results-safety
Study Limitations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
So, will this study change practice? ,[object Object],[object Object],[object Object]
Chemoradiation Studies Argiris A. Update on chemo radiotherapy for head and neck cancer . Curr Opin Oncol 2002;14:323-329.
Future Studies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Future studies ,[object Object],[object Object],[object Object],[object Object],[object Object]
Discussion- Cancer therapy trials ,[object Object],[object Object],[object Object]
References ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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