Modified TPEx as First-line Treatment for Recurrent and/or Metastatic Head and Neck Cancer.

Background/aim: To retrospectively evaluate the efficacy and safety of modified TPEx (docetaxel 60 mg/m on day 1, cisplatin 60 mg/m on day 1, and weekly cetuximab 250 mg/m with loading dose of 400 mg/m) followed by maintenance cetuximab as first-line treatment for inoperable recurrent and/or metastatic squamous cell carcinoma of the head and neck.

Patients And Methods: We analyzed 22 Japanese patients receiving modified TPEx every 21 days for four cycles with or without prophylactic granulocyte colony-stimulating factor (G-CSF).

Results: The best overall response rate was 55% [95% confidence interval (CI)=35-73]. The median progression-free survival and overall survival were 8.9 months (95%CI=3.9-10.2) and 14.3 months (95%CI=10.1-28.2), respectively. Without prophylactic G-CSF, Grade 3/4 neutropenia and febrile neutropenia was common (94% versus 20%; p=0.003 and 41% versus 0%; p=0.11, respectively).

Conclusion: The modified TPEx is effective, while prophylactic G-CSF is essential.