Panitumumab plus accelerated-fractionation radiotherapy was not noninferior to cisplatin plus standard-fractionation radiotherapy in patients with locoregionally advanced head and neck squamous cell carcinoma (HNSCC), a study published in JAMA Oncology has shown.1
To compare progression-free survival in patients with locoregionally advanced HNSCC treated with standard-fractionation radiotherapy plus high-dose cisplatin vs accelerated-fractionation radiotherapy plus panitumumab, an anti-EGFR monoclonal antibody, researchers enrolled 320 patients TanyN+M0 or T3-4N0M0 locoregionally advanced HNSCC.
Participants were randomly assigned 1:1 to receive standard-fractionation radiotherapy at a dose of 70 Gy in 35 fractions over 7 weeks plus cisplatin 100 mg/m2 intravenously for 3 doses or accelerated-fractionation radiation treatment at a dose of 70 Gy in 35 fractions over 6 weeks plus panitumumab 9 mg/kg intravenously for 3 doses.
Results showed that no significant difference in progression-free survival between the 2 arms (hazard ratio [HR], 0.95; 95% CI, 0.60-1.50; P =.83). The 2-year progression-free survival rate in the intention-to-treat population was 73% (95% CI, 65-79) with accelerated radiotherapy vs 76% (95% CI, 68-82) with standard radiotherapy.
Because the upper bound of the HR 95% confidence interval exceeded the prespecified noninferiority margin, noninferiority between accelerated-fractionation radiotherapy plus panitumumab and standard-fractionation radiotherapy plus cisplatin could not be proven.
There was also no significant difference in overall survival between the 2 groups. Two-year overall survival was 85% (95% CI, 78-90) and 88% (95% CI, 82-92) with accelerated and standard radiotherapy, respectively.
Of note, there was no significant difference in the incidence of any grade 3 or worse nonhematologic adverse events (P =.25).
The findings ultimately suggest that cisplatin plus standard-fractionation radiotherapy should remain the standard of care for patients with locoregionally advanced HNSCC.
1. Siu LL, Waldron JN, Chen BE, et al. Effect of standard radiotherapy with cisplatin vs accelerated radiotherapy with panitumumab in locoregionally advanced squamous cell head and neck carcinoma. JAMA Oncol. 2016 Dec 8. doi: 10.1001/jamaoncol.2016.4510. [Epub ahead of print]