Three Chemo Drugs Better Than Two for Advanced Head/Neck Cancers

By Serena Gordon
HealthDay Reporter
Wednesday, October 24, 2007; 6:00 PM

Copyright © 2007 ScoutNews, LLC. All rights reserved.

WEDNESDAY, Oct. 24 (HealthDay News) -- The addition of the chemotherapy drug, docetaxel, to the standard two-drug regimen used for head and neck cancers improved the efficacy of the treatment while reducing the toxicity, two new studies report.

The triple drug chemotherapy regimen was so effective that it increased survival in both studies and more than doubled the average overall survival in one of the studies.

"This is a study that demonstrates that a three-drug regimen is better by a substantial amount in terms of survival for head and neck cancer. There was a 30 percent reduction in mortality with less toxicity," said Dr. Marshall R. Posner, lead author of the first study and medical director of the head and neck oncology program at the Dana-Farber Cancer Institute in Boston. "This is a wonderful step forward for patients."

Results from both clinical trials are published in the Oct. 25 issue of the New England Journal of Medicine. Both studies were funded, at least partially, by Sanofi-Aventis, the manufacturer of docetaxel.

About 3 percent to 5 percent of all cancers in the United States are head and neck cancers, according to the National Cancer Institute. That means almost 40,000 Americans are diagnosed with these cancers each year. They most commonly occur in people over 50, and the biggest risk factor for head and neck cancers is tobacco use.

Treatment for these cancers can be difficult, because surgical removal of tumors can affect the way a person chews, talks and swallows. In some cases, it's impossible to surgically remove some of these cancers, because the risk of harm outweighs the potential benefit. The cancer is then referred to as unresectable.

The study done by Posner and his colleagues included 501 people with advanced -- stage III or IV -- head and neck cancers. None of the volunteers had any signs of cancer in areas far from the original tumor site. Posner said his study included people who had both unresectable and resectable tumors.

The study participants were randomly assigned to receive the standard two-drug regimen (cisplatin and fluorouracil) or the new three-drug treatment which included cisplatin, fluorouracil and docetaxel. People in both groups then received seven weeks of weekly chemoradiotherapy (chemotherapy and radiation combined) with carboplatin, and radiotherapy (radiation treatment) for five days a week. Those who became eligible for surgery were able to have surgery six to 12 weeks after completing chemoradiotherapy.