ASTRO 2022: Loplatin combination minimizes toxicity of HNSCC

In patients with head and neck squamous cell carcinoma, induction chemotherapy combined with concurrent loplatin chemoradiotherapy improved safety outcomes
compared with cisplatin-based regimens without sacrificing efficacy.

For patients with locally advanced head and neck squamous cell carcinoma (HNSCC), docetaxel (Docefrez) gallopplatin (TL) induction chemotherapy plus concurrent roplatin chemoradiotherapy (CRT) versus docetaxel plus cisplatin plus 5-fluorouracil (TPF) induction chemotherapy plus cisplatin CRT
based on early findings in a Phase 3 trial (NCT03117257) presented at the 2022 American Society of Radiation Oncology (ASTRO) Annual Meeting.

After a median follow-up of 35 months (range 19-57), the researchers found no significant difference in short-term objective response rate (ORR) between the TL and TPF groups (P = .
208).

In addition, the 2-year overall survival (OS) rate was 54.
3% in the TL group, 66.
7% in the TPF group (P = .
342), and the 2-year progression-free survival (PFS) was 61.
1% and 71.
4% (P = .
200),
respectively.

Researchers also report that TL exhibits a better safety
profile during induction chemotherapy than TPF regimens.
Grade 1/2 nausea or vomiting occurred in 10% of patients in the TL group and 51% in the TPF group (P <.
001.
023.
001 crt vs .
010 vs.
tl TPF .
009>

"For locally advanced [HNSCC, roplatin] combination regimen induction chemotherapy after [lopplatin] concurrent CRT may be a new option
for second-line therapy.
【Loplatin regimen】 has obvious advantages in reducing toxic side reactions, and the efficacy needs further follow-up verification
.
The researchers wrote
.

The trial enrolled 87 patients with pathologically confirmed locally advanced HNSCC between August 2016 and October 2019, all of whom were randomized to TL and TPF groups in timed chemotherapy mode
.
Included if the patient has not undergone surgery and is in stages III to IVb; or surgical and stage IVa or IVb disease, stage III disease at the base of the tongue or primary site of the hypopharynx, or postoperative naked or residual stage III disease
.
Other requirements include a Kanofsky score of 70 points or higher, expected survival at 6 months or more, and endogenous creatinine clearance of 55 ml or higher per minute
.

At the same time, patients who had received epidermal growth factor targeted therapy or who had previously received chemotherapy or immunotherapy for the primary tumor were excluded from
the trial.

These data, while limited by a limited group of participants, suggest that the lopplatin regimen may be a promising second-line option
for this patient population.

Resources:

Zhang M, Wu W, Jin F, et al.
A randomized phase III trial observed the feasibility and safety of loplatin combination regimen of sequential loplatin in locally advanced head and neck SCC.
Presented at 2022 American Society for Radiation Oncology (ASTRO) Annual Meeting; October 23-26, 2022; San Antonio, TX; abstract 2637.
Accessed October 26, 2022.