AUTHOR=Malhotra Binu , Bellile Emily Light , Nguyen Nghia Pham Trung , Fung Vicki Kay , Slack Matthew , Bilich Rebecca , Papagerakis Silvana , Worden Francis 

TITLE=Carboplatin-Pemetrexed in Treatment of Patients with Recurrent/Metastatic Cancers of the Head and Neck; Superior Outcomes in Oropharyngeal Primaries

JOURNAL=Frontiers in Oncology

VOLUME=4

YEAR=2015

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2014.00362

DOI=10.3389/fonc.2014.00362

ISSN=2234-943X

ABSTRACT=<p><bold>Background:</bold> Platinum-based therapy in combination with 5-fluorouracil with cetuximab has shown the best survival in pts with recurrent/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). The purpose of this study is to evaluate the efficacy and tolerability of carboplatin, pemetrexed and to assess differential outcomes in patients with oropharyngeal primary and HPV related disease.</p><p><bold>Patients and Methods:</bold> The charts of consecutive patients with R/M SCCHN were reviewed. All patients receiving at least one cycle of the two-drug regimen (pemetrexed 500 mg/m<sup>2</sup>, carboplatin area under the curve of five intravenously), were included for assessment of response, safety, toxicity, and survival.</p><p><bold>Results:</bold> A total of 86 patients received this regimen between January 2008 and December 2012, of which, 63 were included in this analysis. Forty-one percent (26) of the patients had cancers of the oropharynx, and of those, 50% had HPV-positive disease, 32% (20) had cancers of the larynx, and 24% (15) of the oral cavity. Median number of cycles administered was 4 (range 1–14 cycles) with 50% of the patients receiving four or more cycles. Half the patients achieved stable disease as their best response, 8% (5) attained a partial response, 24% progressed on therapy, and the remaining patients (12) could not have their response assessed. On the basis of Kaplan–Meier analysis, median progression-free survival (PFS) was 5.1 months (95% CI 3.2, 6.2) and median overall survival (OS) was 9.4 months (95% CI 4.3, 13.1). Among pts with oropharyngeal primary (<italic>n</italic> = 26), median PFS was 6.4 months (95% CI 2.8, 7.9) and median OS was 16.6 months (95% CI 9.6, 19.5). Among HPV+ pts (<italic>n</italic> = 13), median PFS was 7.0 months (95% CI 4.8, ne) and median OS was 17.1 months (95% CI 11.2, 21.7).</p><p><bold>Conclusion:</bold> Combination carboplatin-pemetrexed is an effective and well-tolerated treatment, associated with a median PFS of 5.1 months and a clinical benefit in at least 57% of the patients treated.</p>