Drug trio increases survival rate in head and neck cancers

Adding a third drug to a standard chemotherapy combination can dramatically improve the survival of patients with advanced head and neck cancer, according to research at Dana-Farber Cancer Institute in Boston.

Previous studies have shown that using combination chemotherapy of cisplatin and 5-fu yields a 25 to 50 percent rate of complete pathological responses (the tumor disappeared). Robert Haddad, MD, and his colleagues found that adding the drug docetaxel (Taxotere) to the cisplatin and 5-fu regimen significantly increased the complete pathological response rate to 89 percent.

Using data obtained from treating 72 patients with locally advanced squamous cell carcinoma of the head and neck, the researchers project that the three-drug combination would result in a 95 percent two-year survival rate and a 90 percent five-year survival rate. The majority of these patients have stage IV disease.

"These results are very encouraging and in all likelihood will translate into a significantly more effective treatment for patients with advanced head and neck cancer," says Haddad. "This patient population historically has had a poor prognosis, but, given these findings, the outlook is more hopeful."

The drug combination is given for three cycles as an initial treatment, known as induction chemotherapy, to shrink tumors prior to several weeks of intense treatment with additional chemotherapy given along with radiation. This "sequential therapy" has brought about the most successful results in patients with these stubborn cancers. Cancers of the head and neck are diagnosed in more than 40,000 people in the United States each year, with about 7,200 deaths.

Based on recent results of Phase III trials of the therapy and on the new data, Haddad, who is also an assistant professor at Harvard Medical School, and his colleagues propose that the three-drug combination be used as the new platform when using induction chemotherapy.