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Cetuximab in the management of nasopharyngeal carcinoma – a narrative review

Published online by Cambridge University Press:  11 September 2019

M S Iqbal ,
D Wilkinson ,
A Tin ,
P Bossi ,
L Gradwell-Nelson ,
J Kovarik ,
J O'Hara  and
C Kelly
M S Iqbal*
Affiliation:
Department of Clinical Oncology, Northern Centre for Cancer Care, Newcastle upon Tyne NHS Hospitals Foundation Trust, UK
D Wilkinson
Affiliation:
Department of Clinical Oncology, James Cook University Hospital, Middlesbrough, UK
A Tin
Affiliation:
Department of Clinical Oncology, James Cook University Hospital, Middlesbrough, UK
P Bossi
Affiliation:
Department of Oncology, Istituto Nazionale dei Tumori, Milan, Italy
L Gradwell-Nelson
Affiliation:
Department of Otolaryngology, Newcastle upon Tyne NHS Hospitals Foundation Trust, UK
J Kovarik
Affiliation:
Department of Clinical Oncology, Northern Centre for Cancer Care, Newcastle upon Tyne NHS Hospitals Foundation Trust, UK
J O'Hara
Affiliation:
Department of Otolaryngology, Newcastle upon Tyne NHS Hospitals Foundation Trust, UK
C Kelly
Affiliation:
Department of Clinical Oncology, Northern Centre for Cancer Care, Newcastle upon Tyne NHS Hospitals Foundation Trust, UK
*
Author for correspondence: Dr Muhammad Shahid Iqbal, Northern Centre for Cancer Care, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK E-mail: [email protected]
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Abstract

Background

Concurrent chemotherapy with radiotherapy is the standard treatment for locoregionally advanced nasopharyngeal cancer. Cetuximab can be used in the treatment of head and neck squamous cell carcinoma. However, the randomised studies that led to approval for its use in this setting excluded nasopharyngeal cancer. In the context of limited data for the use of cetuximab in nasopharyngeal cancer in the medical literature, this review aimed to summarise the current evidence for its use in both primary and recurrent or metastatic disease.

Method

A literature search was performed using the keywords ‘nasopharyngeal neoplasm’, ‘cetuximab’ and ‘Erbitux’.

Results

Twenty studies were included. There were no randomised phase III trials, but there were nine phase II trials. The use of cetuximab in the treatment of nasopharyngeal carcinoma has been tested in various settings, including in combination with induction chemotherapy and concurrent chemoradiotherapy, and in the palliative setting.

Conclusion

There is no evidence of benefit from the addition of cetuximab to standard management protocols, and there is some evidence of increased toxicity. There is more promise for its use in metastatic or locally recurrent settings. This review draws together the existing evidence and could provide a focus for future studies.

Keywords

Nasopharyngeal CarcinomaCetuximabReview
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 10 , October 2019 , pp. 843 - 855
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr M S Iqbal takes responsibility for the integrity of the content of the paper

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