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Randomized Controlled Trial
. 2015;16(2):346-51.
doi: 10.4161/15384047.2014.961881.

Gefitinib, Methotrexate and Methotrexate plus 5-Fluorouracil as palliative treatment in recurrent head and neck squamous cell carcinoma

Vandana Singh Kushwaha  1 , Seema Gupta, Nuzhat Husain, Huma Khan, M P S Negi, Naseem Jamal, Ashim Ghatak
Affiliations
Randomized Controlled Trial

Gefitinib, Methotrexate and Methotrexate plus 5-Fluorouracil as palliative treatment in recurrent head and neck squamous cell carcinoma

Vandana Singh Kushwaha et al. Cancer Biol Ther. 2015.

Abstract

This study compared the efficacy and toxicity of Gefitinib, Methotrexate and Methotrexate plus 5-Fluorouracil (5-FU) in patients of recurrent squamous cell carcinoma of head and neck (SCCHN) treated with palliative intent. Patients with recurrent SCCHN not amenable to curative treatment were randomly assigned to Gefitinib, Methotrexate or Methotrexate plus 5-FU arm. The primary end point was overall survival. Secondary end points of interest were objective response rate, toxicity and quality of life. Total 117 patients were analyzed. Median overall survival and objective response rates were 8.8 months, 7.8 months and 8.1 months and 7.7%, 5.0% and 7.9% in Gefitinib, Methotrexate and Methotrexate plus 5-FU arms respectively with no statistically significant difference between 3 arms. Gefitinib had different toxicity profile compared with other arms. Majority of toxicities were Grade 1 or Grade 2. Gefitinib had significant improvement in quality of life during initial months over Methotrexate. There was no suggestion that Gefitinib significantly prolonged overall survival compared with Methotrexate and Methotrexate plus 5-FU. However, improved Quality of Life with manageable toxicities was observed.

Keywords: ECOG, Eastern Cooperative Oncology Group; EGFR, Epidermal growth factor receptor; HNSCC, Head and neck squamous cell carcinoma; QOL, Quality of life; gefitinib; head and neck; methotrexate; recurrent; squamous cell carcinoma.

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Figures

Figure 1.
Figure 1.
Cumulative survival proportions of 3 groups.
Figure 2.
Figure 2.
QOL of 3 groups over the periods.
Figure 3.
Figure 3.
Microphotograph showing Immunohistochemical expression of EGFR in SCCHN (a) showing negative cytoplasmic and membranous staining (b) showing positive cytoplasmic and membranous staining (DAB × 125 × digital magnification).
See this image and copyright information in PMC

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