scholarly journals Continuous infusion of 5-FU with split-dose cisplatin: An effective treatment for advanced squamous-cell carcinoma of the head and neck

2011 ◽  
Vol 34 (1) ◽  
pp. 8 ◽  
Author(s):  
Zhiguo Luo ◽  
Jianhua Chang ◽  
Ye Guo ◽  
Hui Yu ◽  
Fangfang Lu ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Intravenous Infusion ◽  
Initial Treatment ◽  
Cell Cancer ◽  
Continuous Intravenous Infusion ◽  
Split Dose ◽  
Overall Response

Purpose: The purpose of this study was to determine if a combination chemotherapy, using continuous intravenous infusion of fluorouracil (5-FU) in combination with split-dose cisplatin, in patients with recurrent or metastatic head and neck squamous-cell could improve previously reported clinical outcomes. Methods: Forty-two patients with recurrent or metastatic head and neck squamous-cell cancer were treated by cisplatin (25 mg/m2/day on days 1-3) and 5-FU (750 mg/m2/day for 120 hours; continuous intravenous infusion on days 1 through 5) with a cycle that repeated every 3 weeks. Results: Of the 42 patients, 8 (19.1%) showed complete response and 12 (28.5%) demonstrated a partial response, giving an overall response rate of 47.6%. Response rates were significantly different for patients undergoing initial treatment vs. re-treatment:73.6% (14/19) vs. 25.9% (6/23), respectively (χ2=9.45, P < 0.05). Median time to progression was 7.2 months and median overall survival was 13.7 months. The 1 year survival was 57.1%. Toxicity mainly included myelo-suppression, mucositis, nausea and vomiting. Conclusion: Chemotherapy with 5-FU by continuous intravenous infusion in combination with split-dose cisplatin is effective with a tolerable toxicity profile in patients with recurrent, or metastatic squamous-cell carcinoma of head and neck. The overall response was significantly higher in patients undergoing initial treatment in comparison with patients undergoing re-treatment after relapse.

Phase II study of gemcitabine concurrent with radiation in locally advanced squamous cell carcinoma of head and neck: Trial of the Cancer Research Group Pakistan

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15520-15520 ◽  
Author(s):  
A. A. Javed ◽  
A. Shaharyar ◽  
I. H. Shah ◽  
M. A. Shah ◽  
T. N. Ansari ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Total Dose ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Overall Response Rate ◽  
Response Rate ◽  
Locally Advanced ◽  
Overall Response ◽  
Grade 3

15520 Background: The optimum radiosensitizing dose and schedule of gemcitabine for squamous cell carcinoma of head and neck are not known. The objectives of this study were to evaluate the efficacy and toxicity of weekly gemcitabine as a radiosensitizer concurrent with radical radiotherapy in locally advanced head and neck cancer. Method: Thirty-nine patients with stage III or IV B inoperable carcinoma of head and neck were enrolled. Eligible patients had histopathologically confirmed squamous cell carcinoma with age between 18–70 years. Patients had a KPS >70 with an adequate marrow, hepatic and renal function. No prior chemotherapy or radiotherapy was allowed. Patients with nasopharyngeal, glottic or sub-glottic cancer were excluded. Gemcitabine 150 mg/m2 or a total dose not exceeding 200 mg was given on day 1,8,15,22,29, and 36 during radiation treatment. Gemcitabine was infused in 200 ml of normal saline in 2 hours and radiation was delivered two hours after the completion of gemcitabine infusion. Conventional fractionation was used to deliver a total dose of 66 Gy. CTC version 2.0 of NCI and RTOG/EORTC Late Radiation Morbidity Scoring Scheme were used for evaluation of toxicity and RECIST was used for response evaluation. Results: Only 35 patients were considered evaluable for response. Complete response was seen in 8 (22.9%) (95% CI; 10.4–40.1%), partial response in 25 (71.4%), with an overall response rate of 94.3% (95% CI; 80.8–99.3%). All the thirty-nine patients were evaluable for toxicity. Grade 3 and 4 mucositis was seen in 28 (71.8%) and 2 (5.1%) patients respectively. Grade 3 pharyngeal toxicity was seen in 6 (15.4%). One patient developed pharyngo-cutaneous fistula. Despite vigorous symptomatic and supportive care acute toxicities led to treatment interruption in 16 (41%) of patients. Conclusion: Weekly gemcitabine at a dose of 150mg/m2 concurrent with radiation therapy gives a high overall response rate and a high rate of acute toxicity. No significant financial relationships to disclose.

Vinorelbine, cisplatin, and 5-fluorouracil as initial treatment for previously untreated, unresectable squamous cell carcinoma of the head and neck

Cancer ◽  
1997 ◽  
Vol 79 (7) ◽  
pp. 1394-1400 ◽  
Author(s):  
Vittorio Gebbia ◽  
Glovanni Mantovani ◽  
Antonio Farris ◽  
Biagio Agostara ◽  
Alberto Desogus ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Initial Treatment

scholarly journals P51 Serious pathology mimicking GCA: two cases of carcinoma tongue

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Abdul kayani ◽  
Alwin Sebastian ◽  
Liubov Borukhson ◽  
Madeline Whitlock ◽  
Bhaskar Dasgupta
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Cell Cancer ◽  
Temporal Artery ◽  
Temporal Artery Biopsy ◽  
Alternative Diagnosis ◽  
Poorly Differentiated ◽  
Posterior Tongue

Abstract Background Jaw and tongue pain with constitutional symptoms and raised inflammatory markers are considered pathognomonic ischemic features of giant cell arteritis (GCA). Temporal artery ultrasound (US) (or biopsy) available in GCA fast-track clinics (FTC) for a rapid assessment of patients with suspected GCA. Atypical presentation and negative US or biopsy require further workup to look for an alternative diagnosis. ENT pathology can occur as a mimic of GCA. Herein we discuss two clinical cases of squamous cell cancer tongue presenting with signs and symptoms that resemble GCA. Methods We have put together a case report. Results Case-1: A 58-year-old male with a recent presumed diagnosis of relapsing GCA was referred with worsening visual symptoms and right eye pain despite ongoing steroid treatment (60mg), for consideration of Tocilizumab (TCZ). His initial presentation was 5 months ago with a right parietal and retro-orbital headache and blurred vision. He had a normal eye examination. His C-reactive protein (CRP) was raised (24). He was started on prednisolone 40 mg for GCA with complete resolution of symptoms with normalised CRP within weeks. Several weeks later, symptoms reoccurred. CT brain, abdomen and pelvis was normal and temporal artery biopsy negative. His prednisolone was increased to 60 mg. 6 months later, his jaw and tongue pain worsened, and he was treated with pulsed methylprednisolone. Due to partial response to steroids, he was referred to consider TCZ. He had tender left TMJ with normal temporal artery US. Urgent MRI head and neck revealed a left posterior tongue mass with the histology confirmed poorly differentiated squamous cell carcinoma. He was managed with chemo and radiotherapy. Case-2: A 75 years old female, presented with right scalp pain, tongue pain, painful swallowing and chewing. Her blood investigations were normal except a raised ESR (48) and presumed GCA she was started on steroids (60 mg). she had initially good response but, within a few weeks, her symptoms returned. She was then referred to our FTC. Temporal artery US and biopsy were normal. MRI of the head and neck showed a large mass seen in the right half of the posterior tongue extending into the deep aspect of the anterior tongue. Histology confirmed poorly differentiated Squamous cell carcinoma. She was treated with a combination of chemotherapy and radiotherapy. Conclusion GCA mimics represent a major diagnostic dilemma. FTC helps to stratify the GCA from mimics. Careful evaluation of the history, examination as well as a temporal artery US helps to exclude GCA and aids prompt requesting of appropriate tests to find an alternative diagnosis such as tongue cancers as in our cases. We have now introduced negative weightage for consideration of alternative diagnoses in our GCA probability score. Disclosures A. Kayani None. A. Sebastian None. L. Borukhson None. M. Whitlock None. B. Dasgupta Consultancies; Roche, Sanofi. Grants/research support; Roche.

251 Factors evaluated as predictors of exceptional response to PD-1 inhibitors in patients with head and neck squamous cell cancer

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A272-A272
Author(s):  
Alexander Song ◽  
Ron Ng ◽  
John Heller ◽  
Robin Petro ◽  
Ralph D’Agostino ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Complete Response ◽  
Similar Treatment ◽  
One Year ◽  
Neck Squamous Cell Cancer

BackgroundImmunotherapy has recently emerged as an alternative to traditional chemotherapy in the management of recurrent or metastatic head and neck squamous cell cancer (HNSCC). PD-1 inhibitors were approved for HNSCC in 2016 with ORR of 13–18% and CR of 4%.1, 2 Current research focuses on identifying predictors of response for better patient selection. We present HNSCC patients with exceptional response to PD-1 inhibitors in an attempt to highlight biomarkers that correlated with their remarkable response.MethodsWe analyzed all cases of HNSCC treated with single agent PD-1 inhibitors in the last 4 years at Wake Forest Comprehensive Cancer Center. To identify exceptional responders, we followed the NIH Initiative definition: complete response to drug(s), where complete response is seen in less than 10% of patients receiving similar treatment or partial response lasting at least 6 months, where such response is seen in less than 10% of patients receiving similar treatment. We aimed to test all patients for PD-L1 expression, tumor genomics by Foundation Medicine platform and mutated circulating tumor DNA via Guardant 360 platform.ResultsBased on the above criteria, 11 patients were identified as exceptional responders, 9 of whom had metastatic spread to lung, liver or bones. 7 patients were treated for more than one year, and all achieved CR. 3 patients were treated for less than one year, and all achieved major PR with possible CR to be confirmed with next scans. One patient with metastatic HNSCC achieved CR after just 3 administrations of PD-1 inhibitor and has been in CR for 3.5 years. 9 patients were tested for PD-L1 before starting immunotherapy, and all presented levels above 5% by TPS and above 10% by CPS. Interestingly, three patients older than 75 had the highest PD-L1: 75% by TPS and 100% by CPS in two patients. TMB was found moderate or high in all 8 patients tested before starting immunotherapy. TP53 was found mutated both in tumor and in blood in all but 2 of the 10 tested patients, one of whom is the only HPV positive patient in our series. MSI was stable in all patients.ConclusionsThere are limited reports in the literature of exceptional responders to immunotherapy, particularly among HNSCC patients. High PD-L1 expression, moderate or high TMB and presence of mutated TP53 in both tumor and blood were present in almost all patients, recommending for further investigations as possible predictors of exceptional response to PD-1 inhibitors.Ethics ApprovalThe study was approved by Wake Forest University Institution’s Ethics Board, approval number IRB00056249.ReferencesT.Y. Seiwert, B. Burtness, R. Mehra, et al. Safety and clinical activity of pembrolizumab for treatment of recurrent or metastatic squamous cell carcinoma of the head and neck (KEYNOTE-012): an open-label, multicentre, phase 1b trial. Lancet Oncol 2016;17(7):pp. 956–965.Ferris RL, Blumenschein GJr, Fayette J, Guigay J, Colevas AD, Licitra L, et al. Nivolumab for recurrent squamous-cell carcinoma of the head and neck. N Engl J Med 2016;375:1856–67. 10.1056/NEJMoa1602252

scholarly journals Editorial for the Special Issue “Squamous Cell Cancer of the Head and Neck—Time to Arrive in the 21st Century of Oncology”

2021 ◽  
Vol 22 (4) ◽  
pp. 1592
Author(s):  
Sven Perner ◽  
Christian Idel
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
21St Century ◽  
Squamous Cell ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Special Issue ◽  
Common Cancer

Squamous cell carcinoma of the head and neck (HNSCC) is the sixth most common cancer worldwide [...]

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