Head and Neck Cancer Clinical Trial
Official title:
A Phase II Trial of Cetuximab and Bevacizumab in Patients With Recurrent or Metastatic Head and Neck Cancer
The purpose of this study is to determine if the combination of two new drugs, cetuximab (Erbitux) and bevacizumab (Avastin) can increase the effectiveness of treatment for head and neck cancer. Cetuximab has recently been approved by the FDA for head and neck cancer (that is locally or regionally advanced) when used in combination with radiation therapy. Cetuximab is also approved by the FDA for the treatment of colorectal cancer
Approximately 40,000 new cases of head and neck cancer are diagnosed annually in the United
States 1. Squamous cell carcinomas account for more than 90% of head and neck cancer cases.
Patients with squamous cell carcinoma of the head and neck (HNSCC) usually present with
locoregionally advanced disease. Initial presentation with distant metastasis may occur in
about 10% of all patients. However, recurrence of disease either in local or distant sites
after potentially curative treatment with surgery, radiation, and/or chemotherapy occurs in
more than 50% of patients. Therefore, the majority of patients with HNSCC develop recurrent
or metastatic disease during the course of their illness. These patients have a dismal
prognosis with a median survival of 6-9 months 2-4.
Active single agents in head and neck squamous cell carcinoma include methotrexate,
bleomycin, cisplatin, carboplatin, 5-FU, paclitaxel, docetaxel, and CPT-11. A small
randomized study showed that cisplatin monotherapy prolongs survival compared with best
supportive care 5. Response rates for single agents range between 10-40% 2, 4, 6, 7.
Combination chemotherapy with platinum agents, in spite of achieving higher response rates
(about 30% in phase III trials), has not been shown to produce a survival benefit compared to
single agents in randomized comparisons in recurrent/metastatic head and neck cancer 2, 4.
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