In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 15_suppl ( 2012-05-20), p. 5579-5579
Abstract:
5579 Background: We studied escalating doses of weekly nab-paclitaxel (Abraxane, AB) combined with weekly carboplatin (CP) and daily IMRT in patients with LASCCHN to determine the safety and optimal dosing of AB. The favorable biodistribution of AB, an albumin bound formulation of paclitaxel, may allow for intensified locoregional treatment without increasing normal tissue toxicity. Methods: An AB dose escalation was performed, initially using concurrent weekly CP (AUC = 1.5), Erbitux (ER) and daily IMRT to 70 Gy. After ER was dropped, dose escalation of AB from 20 mg/m2 to 50 mg/m2 was performed in 10 mg/m2 increments using a 3 + 3 study design. Results: A total of 28 patients have enrolled and all have completed treatment. Patients ranged in age from 42 to 72 years old (median = 59), with follow up from 3 to 48 months (median = 25). Most patient had oropharyngeal primaries (n=22) and stage III (n=8) or IV (n=20) disease; 18 were HPV+, 6 HPV- and 4 unknown. Initially 6 patients received weekly AB (20 mg/m 2 ), ER and CP, but ER was dropped due to greater than anticipated mucositis and dysphagia. Subsequently, 3 patients each received CP with AB at 20, 30 and 40 mg/m 2 weekly and a total of 13 received CP with AB at 50 mg/m 2 . The median radiation dose is 70 Gy and the median number of weekly chemotherapy cycles is 7. The primary toxicities were Grade 3 dysphagia, mucositis and dermatitis in 24 of 28 patients. Only 3 (of 28) PEG tubes remain at 4, 6 and 14 months. No DLTs were observed at any dose level. There have been 5 recurrences, with 4 being local-regional. Two patients have died of disease and 26 are alive. Conclusions: Concurrent AB, CP, and IMRT is a safe chemoradiotherapy combination in LASCCHN with early data demonstrating feasibility and efficacy.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2012.30.15_suppl.5579
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2012
detail.hit.zdb_id:
2005181-5
Bookmarklink