Head and neck cancer - historical

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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only.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

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

Radiotherapy

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

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

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 dosing details in abstract PubMed

Cisplatin & Cetuximab

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

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 dosing details in manuscript PubMed NCT00003809
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