In combination with radiotherapy (RT), cetuximab is inferior to cisplatin for the locoregional control of advanced head and neck squamous cell cancer (HNSCC), according to a phase 3 study published in the Journal of Clinical Oncology (2020;JCO2002072. doi:10.1200/JCO.20.02072).
“Our study supports that concurrent cisplatin should remain standard treatment of patients with locoregionally advanced [HNSCC],” explained Maria Gebre-Medhin, MD, PhD, Skåne University Hospital, Lund University, Sweden, and colleagues.
The open-label, phase 3 ARTSCAN III study randomized 298 patients to intravenous cetuximab 400 mg/m2 1 week before the start of radiotherapy followed by 250 mg/m2 per week during radiotherapy or weekly intravenous cisplatin 40 mg/m2 during radiotherapy.
The primary end point of the trial was overall survival (OS). Secondary end points included locoregional control and pattern of failure.
After an unplanned interim analysis, patient inclusion was prematurely terminated.
At 3 years, OS was 88% in the cisplatin arm and 78% in the cetuximab arm (adjusted hazard ratio, 1.63; 95% CI, 0.93-2.86; P = .086). The cumulative incidence of locoregional failures was 23% compared with 9%, respectively. The cumulative incidence of distant failures did not differ between treatment groups.
“Cetuximab is inferior to cisplatin regarding locoregional control for concomitant treatment with RT in patients with locoregionally advanced HNSCC,” concluded Dr Gebre-Medhin and colleagues, adding that additional studies are needed to identify possible subgroups that may benefit from concomitant cetuximab treatment.—Jolynn Tumolo
