Concurrent cisplatin-based chemotherapy versus radiotherapy alone as adjuvant therapy for squamous cell carcinoma of the oral cavity bearing high-risk features

Adjuvant chemoradiation (CRT), with high-dose cisplatin remains standard treatment for oral cavity squamous cell carcinoma (OCSCC) with high-risk pathologic features. We evaluated outcomes associated with different cisplatin dosing and schedules, concurrent with radiation (RT), and the effect of cumulative dosing of cisplatin. An IRB-approved collaborative database of patients (pts) with primary OCSCC (Stage I–IVB AJCC 7th edition) treated with primary surgical resection between January 2005 and January 2015, with or without adjuvant therapy, was established from six academic institutions. Patients were categorized by cisplatin dose and schedule, and resultant groups compared for demographic data, pathologic features, and outcomes by statistical analysis to determine disease free survival (DFS) and freedom from metastatic disease (DM). From a total sample size of 1282 pts, 196 pts were identified with high-risk features who were treated with adjuvant CRT. Administration schedule of cisplatin was not significantly associated with DFS. On multivariate (MVA), DFS was significantly better in patients without perineural invasion (PNI) and in those receiving ≥200 mg/m2 cisplatin dose (p < 0.001 and 0.007). Median DFS, by cisplatin dose, was 10.5 (<200 mg/m2) vs. 20.8 months (≥200 mg/m2). Our analysis demonstrated cumulative cisplatin dose ≥200 mg/m2 was associated with improved DFS in high-risk resected OCSCC pts.

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Adjuvant therapy improves survival in pT4aN0 oral cavity squamous cell carcinoma with bone invasion

American Journal of Otolaryngology ◽

10.1016/j.amjoto.2021.103303 ◽

2022 ◽

Vol 43 (2) ◽

pp. 103303

Author(s):

Gaelen B. Stanford-Moore ◽

Ana Marija Sola ◽

Jason Chan ◽

Ivan El-Sayed ◽

Jonathan George ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Adjuvant Therapy ◽

Oral Cavity ◽

Cell Carcinoma ◽

Squamous Cell ◽

Bone Invasion

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The comparison between weekly and three-weekly cisplatin delivered concurrently with radiotherapy for patients with postoperative high-risk squamous cell carcinoma of the oral cavity

Radiation Oncology ◽

10.1186/1748-717x-7-215 ◽

2012 ◽

Vol 7 (1) ◽

pp. 215 ◽

Cited By ~ 65

Author(s):

Din-Li Tsan ◽

Chien-Yu Lin ◽

Chung-Jan Kang ◽

Shiang-Fu Huang ◽

Kang-Hsing Fan ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

High Risk ◽

Oral Cavity ◽

Cell Carcinoma ◽

Squamous Cell ◽

Weekly Cisplatin

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Postoperative radiotherapy for patients at high risk of recurrence of oral cavity squamous cell carcinoma

The Laryngoscope ◽

10.1002/lary.24938 ◽

2014 ◽

Vol 125 (3) ◽

pp. 630-635 ◽

Cited By ~ 12

Author(s):

Michael P. Herman ◽

Roi Dagan ◽

Robert J. Amdur ◽

Christopher G. Morris ◽

John W. Werning ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

High Risk ◽

Oral Cavity ◽

Cell Carcinoma ◽

Squamous Cell ◽

Postoperative Radiotherapy ◽

Risk Of Recurrence

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Retrospective review of capecitabine as adjuvant therapy in high risk or recurrent squamous cell carcinoma of head and neck (SCCHN).

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.15_suppl.e17043 ◽

2015 ◽

Vol 33 (15_suppl) ◽

pp. e17043-e17043

Author(s):

Poorni Manohar ◽

Eli Sapir ◽

Avraham Eisbruch ◽

Mathew E Spector ◽

Mark E Prince ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

High Risk ◽

Adjuvant Therapy ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Retrospective Review ◽

Recurrent Squamous Cell Carcinoma

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Characteristics of the course of squamous cell carcinoma of the oral cavity depending on the HPV status.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e17579 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e17579-e17579

Author(s):

Pavel V. Svetitskiy ◽

Tatiana A. Zykova ◽

Viktoriya L. Volkova ◽

Irina V. Aedinova

Keyword(s):

Squamous Cell Carcinoma ◽

High Risk ◽

Oral Cavity ◽

Cell Carcinoma ◽

Squamous Cell ◽

Hpv Infection ◽

Lower Grade ◽

Tumor Tissues ◽

Hpv Status ◽

Formalin Fixed Paraffin Embedded

e17579 Background: HPV infection has a positive prognostic value in the treatment of patients with oropharyngeal squamous cell carcinoma. The purpose of the study was to evaluate the effect of HPV status on the course of oral cavity cancer. Methods: Formalin-fixed paraffin-embedded tumor tissues were studied in 34 patients with cancer of the floor of the mouth aged 47-85 years, 3 (8.8%) women and 31 (91.2%) men. All patients had histologically verified squamous cell carcinoma: stage (st) I in 1 (2.9%), II st - 8 (23.5%), III st - 12 (35.3%), IV st - 13 (38.3%); G1 in 15 (44.1%), G2 - 19 (55.9%). HPV DNAs were detected by Real-time PCR. Results: HPV DNAs were found in 12 (35.3%) samples of tumor tissues, including type 6 in 1 (2.9%), 11 in 3 (8.8%), 16 in 6 (17.6%), 35 in 1 (2.9%), 16+35 in 1 (2.9%). HPV+ tumors were more often in women (66.7% vs 32.3% in men), but high-risk HPV types were detected in men only - 8 (25.8%). Among patients aged 47-55 years, HPV+ tumor status was detected in 4 (33.3%), 56-65 years in 7 (53.8%), 66 years and older - in 1 (11.1%). In st I, no HPV+ tumors were observed; st II - 3 (37.5%) HPV+ tumors, low-risk in all; st III - 3 (25%) HPV+ patients, including high-risk in 2 (16.7%); st IV - 6 (46.2%) HPV+ samples, high-risk in all. G1 tumors: HPV+ in 7 (46.7%), HPV- in 8 (53.3%) patients; G2 tumors: HPV+ in 5 (26.3%), HPV- in 14 (73.7%) patients. Among patients with HPV+ tumors, metastases were observed in 5 (41.7%), no metastases - in 7 (58.3%); for patients with HPV- tumors, the values were 12 (54.5%) and 10 (45.5%) respectively. 4 (33.3%) patients with HPV+ tumors died, while 8 (66.7%) survived; for patients with HPV- tumors, the values were 12 (54.5%) and 10 (45.5%) respectively. Conclusions: The development of squamous cell carcinoma of the oral cavity was multidirectional and depended on the HPV status. HPV+ tumors, especially high-risk ones, were more often registered in stages III and IV. HPV+ tumors were more often lower-grade ones and less often metastasized; the mortality rate among patients with HPV+ tumors was lower than with HPV- ones.

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Phase II study of pembrolizumab after chemoradiotherapy (CRT) as adjuvant therapy for locally advanced esophageal squamous cell carcinoma (LA-ESCC) patients at high risk of recurrence following preoperative CRT plus surgery.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.3_suppl.tps259 ◽

2021 ◽

Vol 39 (3_suppl) ◽

pp. TPS259-TPS259

Author(s):

Chih-Hung Hsu ◽

Jhe-Cyuan Guo ◽

Ta-Chen Huang ◽

Hung-Yang Kuo ◽

Chia-Chi Lin ◽

...

Keyword(s):

Clinical Trial ◽

Squamous Cell Carcinoma ◽

High Risk ◽

Adjuvant Therapy ◽

Cell Carcinoma ◽

Phase Ii ◽

Squamous Cell ◽

Phase Ii Study ◽

Free Survival ◽

Risk Of Recurrence

TPS259 Background: LA-ESCC is a potentially curable disease, for which preoperative CRT followed by esophagectomy is a standard-of-care. Previous studies have identified that close/involved margin and lymph node metastasis with extranodal invasion (ENI) in post-CRT surgical specimens are associated with increased risk of recurrence. In CheckMate-577 trial, adjuvant nivolumab significantly improved disease-free survival (DFS) in patients with esophageal cancer treated with preoperative CRT and surgery; in another trial (the “PACIFIC” trial), adjuvant durvalumab has significantly improved overall survival (OS) in stage III non-small cell lung cancer treated with definitive CRT. We hypothesize that adding pembrolizumab to CRT as an adjuvant therapy would improve the outcomes of LA-ESCC patients who are treated with preoperative CRT plus esophagectomy and with high-risk of recurrence. Methods: This single institution single-arm phase II study include patients with histologically confirmed LA-ESCC (AJCC 7th staging system:cT3-4aN0M0 or T1-4aN1-3M0) harboring at least one risk factor (closed/involved margin, ENI, or ypN2-3) in post-CRT surgical specimens. Patients with adenocarcinoma of esophagus or gastroesophageal junction or synchronously diagnosed with a squamous cell carcinoma of aero-digestive way other than ESCC are excluded. Patients enrolled will receive adjuvant weekly cisplatin–CRT (cisplatin, 30mg/m2 for 2 cycles every week; radiotherapy, 180-200 cGy/fraction for 10-13 times) followed by pembrolizumab (200 mg, every 3 weeks, for 18 cycles). The primary endpoint of this study is 1-year relapse-free survival (RFS) rate; and the key secondary endpoints include RFS, 3-year RFS rate, OS, 3-yr OS rate, toxicity and safety. The study, registered with clinical trial ID of NCT03322267, started patient enrollment in Aug 2018. As of Aug of 2020, 11 of 46 planned patients have been enrolled. Clinical trial information: NCT03322267.

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