RadioImmunotherapy for adenoid cystic carcinoma: a single-institution series of combined treatment with cetuximab.

Abstract

BACKGROUND:

Local control in adjuvant/definitive RT of adenoid cystic carcinoma (ACC) is largely dose-dependent. However, some clinical situations do not allow application of tumouricidal doses (i.e. re-irradiation) hence radiation sensitization by exploitation of high endothelial growth factor receptor (EGFR)-expression in ACC seems beneficial. This is a single-institution experience of combined radioimmunotherapy (RIT) with the EGFR-inhibitor cetuximab.

METHODS:

Between 2006 and 2010, 9 pts received RIT for advanced/recurrent ACC, 5/9 pts as re-irradiation. Baseline characteristics as well as treatment parameters were retrieved to evaluate efficacy and toxicity of the combination regimen were evaluated. Control rates (local/distant) and overall survival were calculated using Kaplan-Meier estimation.

RESULTS:

Median dose was 65 Gy, pts received a median of 6 cycles cetuximab. RIT was tolerated well with only one °III mucositis/dysphagia. Overall response/remission rates were high (77,8%); 2-year estimate of local control was 80% hence reaching local control levels comparable to high-dose RT. Progression-free survival (PFS) at 2 years and median overall survival were only 62,5% and 22,2 mo respectively.

CONCLUSION:

While local control and treatment response in RIT seems promising, PFS and overall survival are still hampered by distant failure. The potential benefit of RIT with cetuximab warrants exploration in a prospective controlled clinical trial.

• Authors: Alexandra D Jensen, Jürgen Krauss, Wilko Weichert, Jürgen Debus, Marc W Münter
• Journal: Radiation oncology (London, England) (Radiat Oncol) Vol. 5 Pg. 102 (Nov 03 2010) ISSN: 1748-717X [Electronic] England
• PMID: 21047402 (Publication Type: Journal Article)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Antineoplastic Agents
• Carbon Radioisotopes
• Cetuximab

Topics

• Adult
• Aged
• Antibodies, Monoclonal (therapeutic use)
• Antibodies, Monoclonal, Humanized
• Antineoplastic Agents (therapeutic use)
• Carbon Radioisotopes (therapeutic use)
• Carcinoma, Adenoid Cystic (mortality, radiotherapy)
• Cetuximab
• Combined Modality Therapy
• Disease-Free Survival
• Heavy Ion Radiotherapy
• Humans
• Immunohistochemistry
• Kaplan-Meier Estimate
• Middle Aged
• Radioimmunotherapy (methods)
• Radiotherapy Planning, Computer-Assisted
• Radiotherapy, Intensity-Modulated