Clinical evaluation of cisplatin and 5-fluorouracil plus vinorelbine in patients with advanced head and neck squamous cell carcinoma: a Phase II study

Nel settembre 1992 é stato avviato uno studio sul carcinoma della testa e del collo coordinato dal Professor Vittorio Gebbia del Policlinico di Palermo.

Lo studio (Protocollo 93/1ext.), “Clinical evaluation of cisplatin and 5-fluorouracil plus vinorelbine in patients with advanced head and neck squamous cell carcinoma: a Phase II study” aveva l’obiettivo di dimostrare l’attività e la tollerabilità dell’associazione vinorelbina, cisplatino e 5-fluorouracile in pazienti con carcinoma a cellule squamose della testa e del collo, in progressione e/o in fase metastatica.

Sono stati arruolati 80 pazienti.

Lo studio ha dimostrato che l’associazione è discretamente attiva nel trattamento del carcinoma della testa e del collo in progressione e/o in fase metastatica (risposta complessiva 55%).

Centri partecipanti :                      Ospedale Oncologico di BARI

Oncologia Medica di CAGLIARI

Ospedale Businco di CAGLIARI

Ospedale di CARPI (MO)

Istituto Nazionale Tumori di MILANO

Cattedra Oncol. Medica – Univ. di PALERMO

Ospedale Oncologico di PALERMO

Policlinico di PALERMO

Ospedale Regina Elena di ROMA

Ospedale Civile di SASSARI

Cattedra Oncol. Medica – Univers. di SASSARI

Casa di Cura Villa dei Gerani di TRAPANI

Riferimento Bibliografico:

  • Treatment of recurrent and/or metastatic squamous cell head and neck carcinoma with a combination of vinorelbine, cisplatin, and 5-fluorouracil: a multicenter phase II trial.
    (Gebbia V, Mantovani G, Agostara B, Contu A, Farris A, Colucci G, Cognetti F, Restivo G, Speciale R, Ferrero B, et al.).
    Ann Oncol. 1995 Dec;6(10):987-91.

    Vinorelbine has been demonstrated to be active against squamous cell carcinomas of the head/neck (SCHNC) and lung. This multicenter phase II trial was carried out to evaluate the activity and tolerability of the combination of vinorelbine, cisplatin, and 5-fluorouracil given on an outpatient schedule in a series of 80 patients with recurrent SCHNC.PATIENTS AND METHODS:
    Eighty patients with recurrent and/or metastatic SCHNC were treated with a combination of CDDP 80 mg/m2on day 1, 5-FU 600 mg/m2 as a 4-hour infusion on days 2-5, and vinorelbine 25 mg/m2 on days 2 + 8. This cycle was repeated every 28 days. Most patients had oral cavity, larynx, or oropharynx carcinoma (88%). Forty-seven had previously received surgery alone, two radiotherapy alone, and 31 surgery plus radiotherapy. Seventy-two patients had locoregional recurrency, and eight had distant metastases.RESULTS:
    According to an intent-to-treat analysis, complete response (CR) of a mean duration of 12.7+ months was achieved in 13% of cases (95% CI 5%-21%), and partial response of 8.3+ months in 45% of patients (95% CI 33%-56%), for an overall response rate of 55% (95% CI 43%-65%). Nine patients (11%) showed no change, and 22 (28%) progressed. Five patients were not evaluable for response and toxicity. CR were seen more frequently in patients pretreated with only surgery than in those who had also received radiotherapy (15% vs. 9%; p = 0.7). No statistically significant differences in response rate according to site of primary tumor were found (p = 0.8, NS). The received dose intensities of 5-FU, CDDP, and VNR were 90%, 92%, and 82%, respectively. The overall survival of the series as a whole was 9.7+ months (range 4-27). Toxicity was generally acceptable. Grades 3 and 4 leukopenia were recorded in 11% and 5% of patients, respectively. Noteworthy was the occurrence of pain at the tumor site after vinorelbine administration in 5 patients.CONCLUSION:
    The combination regimen of CDDP, 5-FU and vinorelbine is quite active in the treatment of metastatic and/or recurrent SCHNC. This regimen should be tested as initial treatment in previously untreated patients and compared to a standard regimen in recurrent SCHNC.

    PMID: 8750150   [PubMed – indexed for MEDLINE]

    Download articolo: Ann. Oncol. 1995