Head and neck cancer - historical

The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the NCCN Guidelines. Is there a regimen missing from this list? See the main head and neck cancer page for current regimens.

5 regimens on this page 5 variants on this page

Locally advanced disease, definitive therapy

Bleomycin, Methotrexate, Vinblastine/RT

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Regimen

Study	Years of enrollment	Evidence	Comparator	Comparative Efficacy
Merlano et al. 1988	1983-1986	Phase 3 (E-switch-ic)	Bleomycin, MTX, Vinblastine, then RT	Seems to have superior PFS

Chemotherapy

• Bleomycin (Blenoxane)
• Methotrexate (MTX)
• Vinblastine (Velban)

Radiotherapy

• RT

References

1. Merlano M, Rosso R, Sertoli MR, Bonelli L, Margarino G, Grimaldi A, Benasso M, Gardin G, Corvó R, Scarpati D, Barbieri A, Pallestrini E, Castiglia G, Santelli A, Scasso F, Bottero G, Ciurlo E, Fracchia P, Moratti M, Santi L. Sequential versus alternating chemotherapy and radiotherapy in stage III-IV squamous cell carcinoma of the head and neck: a phase III study. J Clin Oncol. 1988 Apr;6(4):627-32. link to original article PubMed

Recurrent or metastatic disease, first-line therapy

CABO

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CABO: Cisplatin, Amithopterin (Methotrexate), Bleomycin, Oncovin (Vincristine)

Regimen

Study	Years of enrollment	Evidence	Comparator	Comparative Efficacy
Clavel et al. 1994	1984-1987	Phase 3 (C)	1. CF	Seems to have superior ORR
			2. Cisplatin	Superior ORR

Chemotherapy

• Cisplatin (Platinol)
• Methotrexate (MTX)
• Bleomycin (Blenoxane)
• Vincristine (Oncovin)

References

1. Clavel M, Vermorken JB, Cognetti F, Cappelaere P, de Mulder PH, Schornagel JH, Tueni EA, Verweij J, Wildiers J, Clerico M, Dalesio O, Kirkpatrick A, Snow GB; EORTC Head and Neck Cancer Cooperative Group. Randomized comparison of cisplatin, methotrexate, bleomycin and vincristine (CABO) versus cisplatin and 5-fluorouracil (CF) versus cisplatin (C) in recurrent or metastatic squamous cell carcinoma of the head and neck: a phase III study of the EORTC Head and Neck Cancer Cooperative Group. Ann Oncol. 1994 Jul;5(6):521-6. link to original article contains protocol PubMed

Cisplatin & Cetuximab

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Regimen

Study	Years of enrollment	Evidence	Comparator	Comparative Efficacy
Burtness et al. 2005 (ECOG E5397)	1999-2001	Phase 3 (E-esc)	Cisplatin	Did not meet primary endpoint of PFS

Note: Per physician discretion, patients with complete response (CR) could have treatment discontinued 2 cycles past the point at which CR was attained. Patients with partial response (PR) continued on treatment until there was evidence of CR or progression disease. Patients with stable disease (SD) could discontinue treatment after 6 cycles. Patients with progressive disease discontinued therapy.

Chemotherapy

• Cisplatin (Platinol) 100 mg/m² IV once on day 1

Targeted therapy

• Cetuximab (Erbitux) as follows:
  • Cycle 1: 400 mg/m² IV over 2 hours once on day 1, then 250 mg/m² IV over 60 minutes once per day on days 8, 15, 22
  • Cycle 2 onwards: 250 mg/m² IV over 60 minutes once per day on days 1, 8, 15, 22

28-day cycles (see note)

References

1. ECOG E5397: Burtness B, Goldwasser MA, Flood W, Mattar B, Forastiere AA; ECOG. Phase III randomized trial of cisplatin plus placebo compared with cisplatin plus cetuximab in metastatic/recurrent head and neck cancer: an Eastern Cooperative Oncology Group study. J Clin Oncol. 2005 Dec 1;23(34):8646-54. link to original article contains verified protocol PubMed NCT00003809