Neoadjuvant dose-modified docetaxel in squamous cell carcinoma of the head and neck: A phase 3 study

Oral Dis. 2020 Mar;26(2):285-294. doi: 10.1111/odi.13252. Epub 2020 Jan 6.

Abstract

Objective: To evaluate the efficacy and safety of dose-modified docetaxel plus cisplatin and 5-fluorouracil (TPF) in Chinese patients with squamous cell carcinoma of the head and neck (SCCHN).

Materials and methods: This Phase III, open-label, multi-center study included Chinese adults with previously untreated TNM Stage III or IV SCCHN (NCT00995293). Patients were randomized (1:1) to induction chemotherapy with TPF (docetaxel 60 mg/m2 and cisplatin 60 mg/m2 on day 1 and 5-FU 750 mg/m2 per day continuous IV infusion on days 1-5) or PF (cisplatin 75 mg/m2 on day 1 and 5-FU 750 mg/m2 per day on days 1-5) every 3 weeks for 3-4 cycles. The primary endpoint was progression-free survival (PFS).

Results: Median PFS in the TPF (n = 108) and PF (n = 111) groups was 400 days and 342 days (HR = 0.75; 95% CI, 0.53─1.06; p = .227), respectively. Overall response rate was higher for TPF versus PF (76.3% vs. 52.9%; p = .001), although this equalized following radiotherapy (75.0% vs. 73.9%). In the TPF and PF groups, ≥1 treatment-emergent adverse event was experienced by 104 (94.5%) and 110 (93.2%) patients, respectively.

Conclusion: Adding dose-modified docetaxel to PF did not significantly improve PFS but may increase anti-tumor activity in Chinese patients with locally advanced SCCHN.

Keywords: China; docetaxel; dose modified; head and neck cancer.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Cisplatin / administration & dosage
  • Disease-Free Survival
  • Docetaxel / administration & dosage*
  • Fluorouracil / administration & dosage
  • Head and Neck Neoplasms / drug therapy*
  • Humans
  • Middle Aged
  • Neoadjuvant Therapy*
  • Squamous Cell Carcinoma of Head and Neck / drug therapy*
  • Taxoids / administration & dosage
  • Young Adult

Substances

  • Taxoids
  • Docetaxel
  • Cisplatin
  • Fluorouracil

Supplementary concepts

  • TPF protocol