Combination Therapy Doesn’t Unlock Progress

Erlotinib added no benefit to head and neck cancers treated with standard therapy

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) If one cancer therapy doesn't work well, the conventional wisdom is to intensify the treatment. But adding more medications to the mix doesn't always work.

The standard therapy for head and neck cancer involves radiation and chemotherapy. A new study looked to see if adding another medication to this regimen could improve patient outcomes.

Adding Tarceva (erlotinib) to standard therapy for locally advanced squamous cell carcinoma of the head and neck did not improve patient outcomes, according to a new study.

"See your doctor if you start having trouble swallowing."

The recently completed clinical trial was a collaborative effort of physician scientists from around the country. Neil Hayes, MD, MPH, from the University of North Carolina Lineberger Comprehensive Cancer Center was a member of that research team.

Head and neck cancers develop anywhere in the mouth, throat and other parts of the oral cavity. About 41,500 Americans will be diagnosed with these cancers this year, and some 8,000 individuals will die from these diseases.

Standard head and neck cancer therapy involves the use of the chemotherapy agent cisplatin combined with radiotherapy.

Erlotinib targets a molecule that’s seen in a number of different cancers, called epidermal growth factor receptor (EGFR). The medicine is currently approved to treat non-small cell lung cancer and pancreatic cancer. Erlotinib is what's known as a biologic therapy, which works by boosting the patient's immune system to fight off the cancer.

This current trial compared standard therapy with standard therapy plus erlotinib. The 204 participants were randomly assigned to receive standard or combination therapy.

Researchers measured the complete response rate (when cancer disappears after treatment) and the progression-free survival (the length of time a patient lives with cancer without it getting worse).

The complete response rate was higher in the combination therapy group (52 percent) compared to the standard therapy group (40 percent). However, there was no difference in progression-free survival after a follow-up of 26 months.

Dr. Hayes said in a news release, "There has been great enthusiasm and some confusion about the combinations of chemotherapy and biologic therapy such as EGFR inhibitors in conjunction with radiation in the treatment of squamous cell carcinomas of the head and neck. For the moment, the data are clearly showing no added benefit.”

Trial results were published March 4 in the Journal of Clinical Oncology. The trial was supported by Genentech and Astellas Pharma Global, Tarceva manufacturers. Authors disclosed financial relationships with Genentech. Xcenda, and Amerisource Bergen Consulting Services Development.

Reviewed by: 
Review Date: 
March 10, 2013
Last Updated:
March 12, 2013