Originally published as JCO Early Release 10.1200/JCO.2005.02.147 on April 4 2005

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Multicenter, Phase II Study of Cetuximab in Combination With Carboplatin in Patients With Recurrent or Metastatic Nasopharyngeal Carcinoma

From the Cancer Therapeutics Research Group, Department of Clinical Oncology, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China; Taiwan Cooperative Oncology Group, Departments of Otolaryngology and Oncology, National Taiwan University Hospital; Taiwan Cooperative Oncology Group, Division of Cancer Research, National Health Research Institute, Taipei, Taiwan; Cancer Therapeutics Research Group, Department of Clinical Oncology, National University Hospital; Cancer Therapeutics Research Group, Johns Hopkins-National University Hospital International Medical Center, Singapore; Cancer Therapeutics Research Group, Sydney Cancer Center, Sydney, Australia; and Merck KGaA, Darmstadt, Germany

Address reprint requests to Anthony T.C. Chan, MD, FRCP, Department of Clinical Oncology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, HKSAR, China; e-mail: anthonytcchan{at}cuhk.edu.hk

PURPOSE: To evaluate efficacy and toxicity of cetuximab plus carboplatin in recurrent or metastatic nasopharyngeal carcinoma (NPC) resistant to platinum treatment.

PATIENTS AND METHODS: A multicenter, open-label, single-arm, phase II study in patients with epidermal growth factor receptor–expressing NPC who progressed on or within 12 months after termination of platinum-based chemotherapy for recurrent or metastatic disease. Cetuximab was administered at an initial dose of 400 mg/m² followed by weekly doses of 250 mg/m². Carboplatin area under the curve 5 was administered every 3 weeks up to a maximum of eight cycles.

RESULTS: Sixty patients were enrolled (46 males, 14 females; median age, 44.5 years; range, 23 to 64 years), and all patients were included in the intent-to-treat and safety analyses. Of the 59 patients assessable for efficacy, there were seven partial responses (11.7%), 29 patients (48.3%) with stable disease, and 23 patients (38.3%) with progressive disease, giving an overall response rate of 11.7% (95% CI, 4.8% to 22.6%). The median time to progression was 81 days in all patients and was longest in the group of patients with a confirmed response (173 days). The median overall survival time was 233 days in all patients. Six patients (10%) experienced serious treatment-related adverse events. Grade 3 or 4 toxicities occurred in 31 patients (51.7%); of these patients, only 19 (31.7%) were considered to have toxicity related to cetuximab.

CONCLUSION: Cetuximab in combination with carboplatin demonstrates clinical activity and an acceptable safety profile in heavily pretreated patients with recurrent or metastatic NPC who had previously experienced treatment failure with platinum-based therapy.

Supported by Merck KGaA.

Presented in part at the 39th Annual Meeting of the American Society of Clinical Oncology, Chicago, IL, May 30-June 3, 2003, and at the 12th Annual European Cancer Conference Meeting, Copenhagen, Denmark, September 19-25, 2003.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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