According to the results of a Phase I/II clinical trial, treatment of recurrent or metastatic squamous cell cancer of the head or neck with a combination of two targeted therapies-Avastin® (bevacizumab) and Tarceva® (erlotinib)-was well tolerated and provided a benefit to some patients. These results were published in Lancet Oncology.
Head and neck cancers originate in the oral cavity (lip, mouth, tongue), salivary glands, paranasal sinuses, nasal cavity, pharynx (upper back part of the throat), larynx (voice box), and lymph nodes in the upper part of the neck. Squamous cell carcinoma of the head and neck is the most common type of head and neck cancer. Treatment of recurrent or metastatic cancer of the head and neck remains challenging, and researchers continue to explore new approaches to treatment.
Avastin is a targeted anticancer drug that slows or prevents the growth of new blood vessels by inhibiting a protein known as VEGF; this deprives the cancer of oxygen and nutrients. Avastin has been shown to improve treatment outcomes in selected patients with advanced colorectal, breast, and non–small cell lung cancer, and is also being evaluated in other types of cancer.
Tarceva is a targeted anticancer drug that works by blocking a biological pathway referred to as the epidermal growth factor receptor (EGFR) pathway. The EGFR pathway is involved in cell growth and replication. Tarceva has been shown to improve treatment outcomes in selected patients with advanced non–small cell lung cancer or pancreatic cancer and is also being evaluated in the treatment of other types of cancer.
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To evaluate the combination of Avastin and Tarceva among patients with head and neck cancer, researchers conducted a Phase I/II clinical trial. Forty-eight patients were enrolled in the Phase II part of the study. All patients had recurrent or metastatic squamous cell cancer of the head and neck. Study participants received a combination of Avastin and Tarceva.
- Common side effects included rash and diarrhea.
- Three patients had serious (grade 3 or worse) bleeding events.
- Seven patients experienced a complete or partial disappearance of detectable cancer.
- Median progression-free survival was 4.1 months and median overall survival was 7.1 months
These results suggest that the combination of Avastin and Tarceva was generally well tolerated in this population. The researchers also noted that “a few patients seem to derive a sustained benefit.” Eventually it may be possible to identify in advance which patients are most likely to derive a benefit.
Reference: Cohen EEW, Davis DW, Karrison TG et al. Erlotinib and bevacizumab in patients with recurrent or metastatic squamous-cell carcinoma of the head and neck: a phase I/II study. Lancet Oncology. 2009;10:247-57.