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Outcomes from the Part III NRG Oncology RTOG 0920 (NRG-RTOG 0920) trial assessing postoperative radiotherapy with or with out concurrent cetuximab for chosen sufferers with squamous cell most cancers of the top and neck (SCCHN) confirmed that radiotherapy with cetuximab demonstrated superiority as measured by improved disease-free survival, a secondary endpoint.
The research additionally confirmed no enhance in long-term toxicity. The trial outcomes, nevertheless, didn’t present a statistically important enchancment in total survival, the first endpoint. These outcomes have been revealed within the Journal of Medical Oncology.
“Currently, the outcomes for patients with HPV-negative SCCHN remain poor and treatment is associated with a high rate of locoregional failure and death, despite surgical resection with postoperative radiotherapy,” acknowledged Mitchell Machtay, MD, of the Pennsylvania State College Most cancers Institute and the lead creator of the NRG-RTOG 0920 manuscript.
“Given that EGFR is a common hallmark of SCCHN, our hope was that adding cetuximab to postoperative radiotherapy could help improve outcomes for these patients without the burden of additional long-term toxicity.”
NRG-RTOG 0920 enrolled 577 eligible sufferers with SCCHN of the oral cavity, oropharynx, or larynx, and with a number of intermediate-risk components that warranted postoperative radiotherapy, however not excessive dose cisplatin chemotherapy. Most tumors (85%) had excessive EGFR expression.
Sufferers have been randomly assigned to obtain both IMRT (60–66 Gy) with weekly cetuximab (C+RT) or radiotherapy alone (RT). The first goal of this trial was to find out if the addition of cetuximab to radiotherapy improved total survival. Illness-free survival and toxicity have been secondary endpoints.
Total survival at a median follow-up of seven.2 years was not considerably improved (hazard ratio [HR] 0.81; one-sided p=0.075; five-year estimates 76.5% for C+RT and. 68.7% for RT alone) however disease-free survival was (HR 0.75; one-sided p=0.017; five-year estimates 71.7% for C+RT and 63.6% for RT alone).
The profit found with the addition of cetuximab was solely seen within the HPV-negative subpopulation (80% of the sufferers within the trial). Grade 3–4 acute toxicity charges have been 39.7% (RT) and 70.3% (C+RT) (two-sided p
“These data would indicate that adding cetuximab to radiotherapy is an appropriate option for carefully selected patients with HPV-negative disease,” Dr. Machtay added, “particularly those for whom cisplatin-based chemotherapy with radiation is not a good choice.”
Extra info:
Mitchell Machtay et al, Postoperative Radiotherapy ± Cetuximab for Intermediate-Threat Head and Neck Most cancers, Journal of Medical Oncology (2025). DOI: 10.1200/JCO-24-01829
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Radiotherapy with cetuximab could also be superior to radiotherapy alone for sufferers who endure surgical procedure for head, neck most cancers (2025, January 27)
retrieved 27 January 2025
from https://medicalxpress.com/information/2025-01-radiotherapy-cetuximab-superior-patients-surgery.html
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