Naslov
Radiotherapy plus cisplatin (CDDP) or cetuximab (C225) in human papilloma-virus (HPV)- associated oropharyngeal cancer (OPC)? A dilemma finally resolved. An updated meta- analysis

Autori
Suton, P. ; Skelin, M. ; Luksic, I.

Izvornik
Annals of Oncology (0923-7534) 30 (2019), 5; V457-v457

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, ostalo, znanstveni

Ključne riječi
cisplatin, cetuximab, OPC
(cisplatin cetuximab OPC)

Sažetak
Background Human papilloma virus (HPV)- associated oropharyngeal cancer (OPC) is a special entity among head and neck squamous cell carcinomas (HNSCCs) characterised by higher survival rates compared to similar stage HPV-negative OPC. Due to favorable prognosis, a significant interest in ‘’less toxic’’ therapies (de-escalating strategies) in the treatment of HPV-associated OPC had been introduced. One of the approaches included introduction of cetuximab (C225) instead of cisplatin (CDDP) in conjunction with radiotherapy as a definitive treatment option in these patients. The aim of the updated meta- analysis was to compare the efficacy of CDDP vs. C225 given concurrently with radiotherapy as definitive treatment of HPV-associated OPC, with inclusion of the latest trials investigating this specific issue. To our knowledge this is currently the largest investigation on this matter. Methods A systematic literature search was performed for studies published between 2006 and 2018. A total of 1490 citations were obtained and 8 studies met inclusion criteria, resulting in inclusion of 1665 patients in this meta- analysis. Results Analysis of pooled studies showed no significant heterogeneity or publication bias. Two-year overall survival (OS) calculated pooled odds ratio (OR) for CDDP-based chemoradiotherapy vs. C225-based bioradiotherapy, was 0.45 (P < 0.0001). Two- year locoregional recurrence (LRR) calculated pooled OR for CDDP-based chemoradiotherapy vs. C225-based bioradiotherapy was 0.35 (P < 0.0001). Patients receiving CDDP concurrently with radiotherapy had 2.2- and 2.9-fold decreased risk for death from any cause and LRR, respectively. Conclusions According to the evidence demonstrated by our meta-analysis, CDDP-based chemoradiotherapy should remain the standard of definitive treatment of HPV- associated OPC. Further investigations are necessary in order to define optimal treatment in HPV-negative HNSCCs. Legal entity responsible for the study Petar Suton. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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