Efficacy of Paclitaxel and Cetuximab in Recurrent/Metastatic Oral Cancer Cases Following Superselective Intraarterial Chemoradiotherapy: A Retrospective Cohort Study.

Background/aim: The therapeutic efficacy of the paclitaxel (PTX) + cetuximab (Cmab) combination regimen was investigated in patients with recurrence or metastasis after superselective intraarterial chemoradiotherapy (SSIACRT) for oral cancer, and the safety was retrospectively examined.

Patients and methods: All enrolled patients with advanced oral cancer or who had refused surgery over 10 years from December 2012 to December 2022 underwent SSIACRT for 6 to 9 weeks [cisplatin (CDDP): total 160-630 mg/m² and radiotherapy: total 50-70 Gy]. Nine cases (tongue cancer, maxillary gingival cancer, and mandibular gingival cancer; three cases each) were subjected to PTX + Cmab therapy. Recurrence or metastases were observed within six months after the onset of treatment, complicating the conduct of salvage surgery. Cmab (first dose: 400 mg/m² and second and following doses: 250 mg/m²) and PTX (80 mg/m²) were administered weekly.

Results: The overall response rate was 44.4% (four of nine cases), and the disease control rate was 88.9% (eight of nine cases), whereas the median progression-free survival was seven months, and the overall survival was 11 months. Grade 3-4 adverse events were neutropenia in 33.3% of the cases, leukopenia in 55.6%, anemia in 22.2%, and acneiform skin rash in 22.2%. Based on the above, PTX + Cmab therapy for recurrent and metastatic cases after SSIACRT had comparable results to other second-line modalities and enabled to cope with the side effects of myelosuppression.

Conclusion: PTX + Cmab therapy may be an effective treatment mode for recurrent or metastatic head and neck cancer resistant to CDDP after SSIACRT treatment.