RTP On Demand — Head & Neck/Thyroid | Research To PracticeCase: A man in his mid fifties who received cetuximab/radiation therapy for squamous cell carcinoma of the oral cavity
1:45 minutes.
TRANSCRIPTION:
DR COHEN: So this was an African-American gentleman in his midfifties. He was a smoker and developed a retromolar trigone tumor oral cavity tumor, squamous cell carcinoma. He was T3N0, so Stage III disease. And presented to us with a creatinine hovering between 2 and 2.4. So with all that in mind, here’s a patient who we chose to treat with concurrent chemotherapy/radiation, or systemic therapy/radiation, but we didn’t want to use platinum because of the renal dysfunction. And in that scenario there are, of course, a couple of options, but one of them that has Phase III Level 1 evidence to support it is cetuximab. And so we know that radiation versus cetuximab/radiation, there’s a benefit to the addition of cetuximab. It’s actually about a 10% absolute improvement in overall survival, both at 3 years and at 5 years. And so we chose to treat this gentleman with cetuximab and radiation knowing that we didn’t need to worry about the renal dysfunction. DR LOVE: So how did this man tolerate treatment? DR COHEN: He did very well. We, of course, monitored his renal function throughout and monitored his hydration. He was not on dialysis. He had chronic renal failure but wasn’t requiring dialysis. And he did fairly well with therapy. He had the typical side effects, the skin rash with cetuximab, which we’ve learned to manage over the years and manage effectively. He didn’t need any dose reductions or interruptions. And right now still remains disease free about a year and a half now from primary therapy. |