TITLE:
Concurrent Nimotuzumab with Radiation Therapy in Locally Advanced Cancers of Oropharynx and Hypopharynx: A Review of 6 Cases
AUTHORS:
B. Ravi Shankar, Poojar Kiran, B. V. Madhavi, E. Vijay
KEYWORDS:
Squamous Cell Carcinoma of the Head and Neck (SCCHN), Nimotuzumab, Epidermal Growth Factor Receptor (EGFR), Chemoradiation Therapy
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.6 No.4,
April
30,
2015
ABSTRACT:
Background: The prevalence of head and
neck cancers in the world is around 57% and predominantly occurs in Asian
countries. It accounts for 30% of all cancers in India. The cure rate of
locally advanced squamous cell carcinoma of the head and neck (SCCHN) has only
30% - 60% even after combined therapeutic approaches. Epidermal Growth Factor
Receptor (EGFR) antagonists are the most researched targets in the management
of head and neck cancers. Claims at superior tumor control and additional
survival benefit without any added toxicity make it an attractive option. With
this case series we intend to see how nimotuzumab, a humanized monoclonal
antibody, fares in difficult cases of head and neck cancers. Case Description:
In this case series, total six patients of locally advanced cancer of head and
neck region were treated weekly using cisplatin and nimotuzumab concurrently
with radiation therapy (RT) for 6 - 7 weeks. Depending upon the disease stage
as well as the general condition of the patient, different dose cycles and
radiation doses were tailored. Patients were monitored for regular physical
examinations and hematological tests followed by pre and post treatment
computed tomography (CT) scans, Fludeoxyglucose positive emission tomography
(FDG PET-CT) scans, and histopathology. All patients were assessed for
toxicities and managed consequently. After completion of radiation and
follow-up, 6 weeks later post treatment CT scans were carried out. Conclusion:
This case series shows that combination of chemoradiation with nimotuzumab
achieved good response rates with no evidence of residual disease/disease
progression on follow-up. The patients’ tolerability with combination therapy
was good and toxicity was acceptable. Nimotuzumab was found beneficial in
combination with chemoradiation for locally advanced head and neck cancers.