Concurrent radiotherapy plus epidermal growth factor receptor inhibitors in patients with human papillomavirus-related head and neck cancer

Bella Pajares Hachero; Lidia Pérez Villa; José Manuel Trigo Pérez; María Dolores Toledo Serrano; Martina Álvarez Pérez; Begoña Jiménez; José Antonio Medina Carmona; Vanessa de Luque; José Manuel Jerez Aragonés; Emilio Alba

Ayuda

Concurrent radiotherapy plus epidermal growth factor receptor inhibitors in patients with human papillomavirus-related head and neck cancer

Autores: Bella Pajares Hachero, Lidia Pérez Villa, José Manuel Trigo Pérez, María Dolores Toledo Serrano, Martina Álvarez Pérez, Begoña Jiménez, José Antonio Medina Carmona, Vanessa de Luque, José Manuel Jerez Aragonés , Emilio Alba
Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 16, Nº. 4, 2014, págs. 418-424
Idioma: inglés
Texto completo no disponible (Saber más ...)
Resumen
- Purpose Concurrent radio-chemotherapy (RT-CT) is the standard treatment for locally advanced head and neck squamous cell carcinoma (LA-HNSCC), but RT plus epidermal growth factor receptor (EGFR) inhibitors is an effective option when CT is not appropriate. Human papillomavirus (HPV) is associated with an improved prognosis in LA-HNSCC; however, it has not been fully studied as a prognostic factor after RT + EGFR inhibitors.
  
  Experimental design Immunohistochemical expression of p16INK4A and PCR of HPV16 DNA were retrospectively analyzed in tumor blocks from 52 stage III/IV LA-HNSCC patients treated with RT + EGFR inhibitors. Disease-free survival (DFS) and overall survival (OS) were analyzed by the Kaplan�Meier method.
  
  Results DNA of HPV16 was found in six of 52 tumors (12 %) and p16 positivity in eight tumors (15 %). After a median follow-up time of 45 months (6�110), p16-positive patients treated with RT + EGFR inhibitors showed an improved DFS (2-year DFS 75 vs. 44 %, HR 0.25, 95 % CI 0.06�0.99, p = 0.047) compared with p16-negative patients. These differences were outperformed when compared by HPV16 status (2-year OS rates of 83 vs. 58 %, HR 0.17, 95 % CI 0.02�0.99, p = 0.049 and 2-year DFS rates of 83 vs. 45 %, HR 0.17, 95 % CI 0.02�0.99, p = 0.049). In the Cox regression analysis with OS as the end point, ECOG 0�1 was the only prognostic factor independently associated with a good prognosis in the multivariable analysis.
  
  Conclusion In this study, p16/HPV16-positive patients with LA-HNSCC treated with RT + EGFR inhibitors showed a better survival, not confirmed in multivariate analysis.