S-1 MONOTHERAPY FOR RECURRENT OR METASTATIC SQUAMOUS CELL CARCINOMA OF THE HEAD AND NECK AFTER PROGRESSION ON PLATINUM-BASED CHEMOTHERAPY

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Abstract

Background

Platinum compound plays pivotal roles in the treatment of squamous cell carcinoma of the head and neck (SCCHN).

Objective

The objective was to evaluate the efficacy of S-1 monotherapy in patients with recurrent or metastatic squamous cell carcinoma of the head and neck (R/M-SCCHN) after failure of platinum-based chemotherapy.

Methods

We retrospectively analyzed 39 consecutive patients with R/M-SCCHN who received S-1 monotherapy after failure of platinum-based chemotherapy or chemoradiotherapy at the Shizuoka Cancer Center between August 2003 and October 2010. S-1 was given orally twice daily (80 mg/m2/day) for 28 days followed by a 14-day rest.

Results

The median follow-up period in survivors was 31.5 months. Among 38 patients with measurable lesions, 9 (24%) showed partial response and 15 (39%) showed stable disease. The median progression-free survival (PFS) was 4.9 months and the median overall survival was 13.2 months. The median PFS for oropharyngeal cancer (n = 7) was significantly longer than for other cancers (n = 32) (14.9 versus 4.7 months, P = 0.035). The response rate in patients with recurrence-free interval (RFI) since last platinum >6.0 months was significantly better than RFI <6.0 months (40% versus 13%, P = 0.0102). RFI >6.0 months also showed a significantly better PFS (6.0 versus 2.6 month, P = 0.045). The frequency of grade 3/4 toxic effects was <10%.

Conclusions

S-1 monotherapy shows promising signs of efficacy and tolerability in patients R/M SCCHN after failure of platinum-based chemotherapy in this retrospective cohort, and warrants further investigation in this population.

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