ScienceDirect Publication: Oral Oncology,

Induction chemotherapy in head and neck cancers: Results and controversies

Publication date: August 2019Source: Oral Oncology, Volume 95Author(s): Max Gau, Andy Karabajakian, Thibaut Reverdy, Eve-Marie Neidhardt, Jérôme FayetteAbstractStandard treatment for locally advanced head and neck squamous cell carcinoma (LAHNSCC) consists mainly of concurrent chemoradiation (CCR) but induction chemotherapy (IC) by docetaxel-cisplatin-fluorouracil (TPF), followed by CCR, is a strong option. Comparative trials suggest that IC and CCR are equivalent, and some trials suggest superiority...

ScienceDirect Publication: Oral Oncology

14h

Induction chemotherapy in head and neck cancers: Results and controversies 14h
via ScienceDirect Publication: Oral Oncology
Publication date: August 2019

Source: Oral Oncology, Volume 95

Author(s): Max Gau, Andy Karabajakian, Thibaut Reverdy, Eve-Marie Neidhardt, Jérôme Fayette

Abstract
Standard treatment for locally advanced head and neck squamous cell carcinoma (LAHNSCC) consists mainly of concurrent chemoradiation (CCR) but induction chemotherapy (IC) by docetaxel-cisplatin-fluorouracil (TPF), followed by CCR, is a strong option. Comparative trials suggest that IC and CCR are equivalent, and some trials suggest superiority of IC, whereas none shows inferiority. IC might have less interest in oropharyngeal cancer (more often linked to HPV infection). When functional laryngeal preservation is the patient’s priority, essays strongly suggest that IC is the best treatment. There is little data about a less toxic regimen of IC, but several schemes are promising and need to be developed. An early selection of responders to IC by metabolic imaging must be considered. Intensification attempts with cetuximab were too toxic and unsafe, but trials with immunotherapy are ongoing to enhance TPF efficacy. After IC, CCR either with cetuximab or cisplatin seems to be equally effective.