Cetuximab-based Therapy in Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma: Experience From an Area in Which Betel Nut Chewing Is Popular

Background: This study was undertaken to evaluate the efficacy and safety of cetuximab-based therapy in recurrent/metastatic head and neck squamous cell carcinoma (HNSCC) in an area in which betel nut chewing is popular. Methods: Twenty-five patients were enrolled in the study from 2004 to 2008, of whom 13 received first-line cetuximab plus chemotherapy and 12 received second-line cetuximab with or without chemotherapy after the failure of cisplatin. Results: In the first-line chemotherapy group, the overall response [complete response (CR) plus partial response (PR)] was 54% and disease control rate [CR + PR + stable disease (SD)] was 62%. In the cisplatin-failure therapy group, the overall response was 16.7% and disease control rate was 50%. Median overall survival (OS) and time to progression (TTP) in the first-line chemotherapy group were 857 days and 147 days, respectively. In the cisplatin-failure therapy group, median OS and TTP were 371 days and 136 days, respectively. The most common grade 3/4 toxicity in both groups of patients was infection/fever (23% in the first-line group, 50% in the cisplatin-failure group), followed by neutropenia (23% in the first-line group, 25% in the cisplatin-failure group). Conclusion: Cetuximab-based therapy is an effective and safe treatment choice for recurrent/metastatic HNSCC in areas where betel nut chewing is popular.