In its September meeting 2006, the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMEA) gave a positive opinion to include the use of docetaxel in combination with the current standard treatment - cisplatin and 5 – fluorouracil – for the induction treatment of patients with inoperable locally advanced squamous cell carcinoma of the head and neck. On October 18, the US Food and Drug Administration (FDA) gave its approval to the new treatment as well. According to Steven Galson, M.D., director of FDA's Center for Drug Evaluation and Research, it will "provide prescribers with a new treatment option that has been shown to help slow the spread of the disease and prolong patients' survival."
This drug – label extension of Taxotere® (docetaxel) was possible due to the EORTC 24971 phase III, open label randomized trial, involving 358 patients, evaluating the benefit derived from docetaxel - based combination in inoperable locally advanced head and neck cancer.
Patients treated with the regimen prior to surgery or radiation had significantly longer median overall survival compared to a standard treatment of cisplatin and 5-fluorouracil; with a 28 percent risk reduction of the, 18.6 vs 14.5 months (p=0.0128). Patients receiving the docetaxel-based regimen also had a significantly longer time-to-disease progression of 11.4 months, compared with 8.3 months (P=0.015) for the patients receiving standard therapy. These results have been associated to an improvement of the safety profile.
"Very few treatment options are currently available for patients with head and neck cancer", said Jan B. Vermorken, MD, PhD, Head of Oncology Department, University Hospital Antwerp and Chair of the EORTC Head and Neck Cancer Group and Principal Investigator of the EORTC 24971 study. "EORTC 24971/TAX 323 is the first study to identify a neoadjuvant chemotherapy regimen that extended life for patients with inoperable head and neck cancer; so a European approval may offer physicians another treatment option to manage this disease."
"This label extension once again exemplifies nicely how the pharmaceutical industry and academic clinical research bring about innovation in cancer research. I am confident that an increase in these partnerships will prove to be extremely fruitful for cancer research in Europe", adds Françoise Meunier, MD, PhD, Director General of the EORTC.
About the EORTC 24971 Trial
Patients in the trial were randomly assigned to receive one of two treatments. Of the 358 participants, 177 received an infusion of docetaxel 75 mg/m2 plus cisplatin 75 mg/m2 on day one and a five-day continuous infusion of 5-fluorouraci (5-FU) 750 mg/m2 and 181 patients received an infusion of a standard treatment consisting of cisplatin 100 mg/m2 on day one followed by a five-day continuous infusion of 5-fluorouracil (5-FU) 1000 mg/m2/d. Treatment cycles were repeated every three weeks for a total of four cycles. Patients received radiation therapy following chemotherapy within four to seven weeks after completing the last cycle of chemotherapy. Radiation therapy was administered five days a week for seven weeks. Patients receiving the cisplatin and 5-fluorouracil (5 – FU) regimen showed greater grade 3-4 nausea (7/2% vs. 0.6%), vomiting (5.0% vs. 0.6 %) stomatitis (11% vs. 4.0 %) during chemotherapy and more toxic deaths (5.5 vs. 2.3 % of the total number of patients) when compared to the docetaxel-based regimen.
Patients treated with the docetaxel-containing regimen experienced significantly less deterioration of their Global Health Score compared to those treated with the standard regimen. The Performance Status Scale was also significantly in favor of the docetaxel-containing regimen. The head and neck subscales of the Performance Status Scale are designed to measure disturbances of speech and eating. Median time to first deterioration of WHO performance status was longer in the docetaxel-arm with a 30% risk reduction of WHO performance status deterioration (p=0.0158). The EORTC trial was supported by Sanofi-Aventis.
About Head and Neck Cancer
More than 640 000 people worldwide are diagnosed with head and neck cancer every year; and more than 350 000 die from the disease annually. Head and neck cancer is a group of many related diseases that mostly begin in the cells that line the mucosal surfaces in the head and neck area such as the mouth, nose, and throat. The term encompasses cancers of the oral cavity, salivary glands, paranasal sinuses and nasal cavity, pharynx, larynx and lymph nodes in the upper part of the neck.
About the EORTC
Created in 1962, the European Organisation for Research and Treatment of Cancer (EORTC) is a not-for-profit international cancer research organisation under the Belgian Law.
EORTC has the mission to develop, conduct, coordinate and stimulate laboratory and clinical research in Europe to improve the management of cancer and related problems by increasing survival but also patients' quality of life. The ultimate goal of the EORTC is to improve the standard of cancer treatment in Europe, through the development of new drugs and other innovative approaches, and to test more effective therapeutic strategies, using drugs which are already commercially available, or surgery or radiotherapy. EORTC has the aim to facilitate the passage of experimental discoveries into state-of-the-art treatment by keeping to a minimum the time lapse between the discovery of new anti-cancer agents and the implementation of their therapeutic benefit for patients with cancer.
EORTC promotes multidisciplinary cancer research in Europe and is linked to other leading biomedical research organisations around the world. EORTC research takes place in over 200 hospitals, universities and cancer centres in 32 countries and the unique network of investigators of EORTC comprises more than 2000 clinicians collaborating on a voluntary basis in 20 multidisciplinary groups.
For any further information related to the research activities of the EORTC, please consult the website www.eortc.be. *****
Related Press Releases:
FDA: FDA Approves New Treatment for Advanced Head and Neck Cancer http://www.fda.gov/bbs/topics/NEWS/2006/NEW01493.html
EMEA: Post-authorization summary of positive opinion on Taxotere http://www.emea.eu.int/pdfs/human/opinion/37730706en.pdf
For further information, please contact:
Jan B. Vermorken, MD, PhD
Head of Oncology Department
UNIVERSITY HOSPITAL ANTWERP Wilrijkstraat 10
BE 2650 Edegem
Phone: +32 3 8213954
Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
Published on PsychCentral.com. All rights reserved.