Effect of cetuximab on development of viral infectious complications in laryngeal cancer.
e17578 Background: Cytostatic treatment was shown to influence significantly reactivation of latent viral infections. Our purpose was to study the possible effect of cetuximab on activation of herpesvirus infections. Methods: The blood serum of patients with histologically confirmed laryngeal squamous cell carcinoma was studied before and after chemotherapy. The main group included 9 pts receiving cetuximab+cisplatin+5-fluorouracil, the control group – 9 pts, cisplatin+5-fluorouracil. Antibodies (AB) against viral proteins were detected by ELISA. Results: 6 (66.7%) pts of the main group had primary advanced cancer, 3 (33.7%) – recurrent laryngeal cancer; in control group - 7 (77.7%) and 2 (22.2%), respectively. All pts in both groups were seropositive for HSV 1,2, CMV and EBV before chemotherapy; 4 (44.4%) pts in main group and 7 (77.8%) controls were HPV 6 seropositive. Serological markers of activation of herpes virus infection (IgM or IgG against early viral proteins) after chemotherapy were detected in the main group in 8 (88.9%): HSV 1,2 - 5 (55.6%), CMV - 2 (22.2%), EBV - 3 (33.3%). HSV 1,2, CMV and EBV infections in the control group were activated equally often and found in 3 (33.3%) pts. Clinical signs of herpes virus infection were not observed in either group. A sharp decline in AB titers, sometimes up to their complete disappearance, was registered in 3 (33.3%) pts in the main group and in 6 (66.7%) controls. 1 pt of the main group showed a decline in EBV AB titers and absence of HPV 6 AB titers, 1 pt - a decline in CMV and EBV AB, 1 pt - a decline in HSV 1,2, CMV and EBV AB and absence of HPV 6 AB titers. 2 pts of the control group showed a decrease in HPV 6 AB, 2 pts – their absence, 2 pts – absence of HPV 6 AB and a decline in HSV 1,2, CMV and EBV AB. It could be associated with a greater degree of bone marrow hematopoiesis inhibition during cytostatic therapy. Lymphopenia was registered in the control group more frequently than in the main one. Conclusions: Cetuximab inclusion into chemotherapy does not have an additional negative impact on the development of viral infectious complications. A higher rate of registration of specific antibodies typical of the acute infection phase in the cetuximab group could indicate an adequate response to viral infection.