Deployment of Cisplatin in Veterans With Oropharyngeal Cancer: Toxicity and Impact on Oncologic Outcomes

Authors

Ola Soliman
David C Wilde
Jan O Kemnade
Anita L Sabichi
George Chen
Albert Chen
Samantha N Little
Andrew T Huang
David J Hernandez
Vlad C Sandulache

Publication Date

8-1-2023

Journal

Laryngoscope Investigative Otolaryngology

DOI

10.1002/lio2.1115

PMID

37621289

PMCID

PMC10446265

PubMedCentral® Posted Date

7-14-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

cetuximab, cisplatin, creatinine, distant metastasis, locoregional recurrence, oropharyngeal squamous cell carcinoma, Veteran

Abstract

OBJECTIVE: Cisplatin forms the backbone of systemic chemotherapy treatment for oropharyngeal squamous cell carcinoma (OPSCC). The ideal cisplatin dosing regimen remains yet to be fully defined for achieving optimal efficacy and toxicity profiles in patients with comorbidity.

METHODS: We retrospectively reviewed oncologic and toxicity data for patients with OPSCC treated at the Michael E. DeBakey Veterans Affairs Medical Center between 2000 and 2020 who initiated curative intent, definitive chemo-radiation with one of three single agent regimens: high dose (HD) cisplatin, low dose (LD) cisplatin or cetuximab.

RESULTS: Patients with HPV-associated tumors and nonsmokers demonstrated improved overall and disease-free survival along with locoregional and distant metastatic control regardless of chemotherapy regimen. Regardless of regimen selection, patients which received a cumulative cisplatin dose ≥200 mg/m

CONCLUSIONS: Both HD and LD cisplatin regimens can be safely delivered to a Veteran OPSCC patient population which should allow for straightforward application of conclusions drawn from completed and active clinical trials testing cisplatin regimens.

LEVEL OF EVIDENCE: 4.