HEAD AND NECK Outcome of patients treated with palliative weekly Paclitaxel plus Cetuximab in recurrent head and neck cancer after failure of platinum-based therapy Aaron E. Sosa • Juan J. Grau • Luis Feliz • Vero ´nica Pereira • Diego Alcaraz • Carmen Mun ˜ oz-Garcı ´a • Miguel Caballero Received: 12 December 2012 / Accepted: 25 April 2013 Ó Springer-Verlag Berlin Heidelberg 2013 Abstract Few therapeutic options are available for recur- rent/metastatic head and neck cancer when progression occurs after initial chemotherapy. We analyzed retrospectively the efficacy of weekly Paclitaxel plus Cetuximab as second line of palliative chemotherapy. Patients with squamous carcinoma of head and neck with documented progression after initial treatment were enrolled. Tumor response was evaluated through the response evaluation criteria in solid tumor criteria. The retrospective analysis focused on overall survival (OS) and progression-free survival (PFS). Between 2008 and 2011, 33 consecutive patients were treated. A response rate of 55 % was observed, with median response duration of 5.0 months (95 % CI 3.3–11.1). The median PFS was 4.0 months (95 % CI 2.9–5.0) and the median OS time was 10.0 months (95 % CI 7.9–12.0). Acne-like rash/Folliculitis and chronic anemia were the most common adverse events. A weekly schedule of Paclitaxel plus Cetuximab is a promising regimen for patients with advanced head and neck cancer after failure of platinum- based therapy. Good tolerance of this treatment suggests that would be used in fragile patients. Keywords Head neck Á Cancer Á Carcinoma Á Cetuximab Á Chemotherapy Á Paclitaxel Introduction Platinum-based combination regimens are considered the standard first-line treatment in patients with recurrent or metastatic head and neck cancer [1, 2]. Nevertheless, once patients progress to platinum-based chemotherapy, thera- peutic options are limited and most of them receive only best supportive care [3, 4]. Further treatment for patients with good performance status includes second-line chemotherapy, but it often shows limited efficacy: a retrospective analysis of different regimens evidenced objective response rate (RR) of about 3 %, and median overall survival (OS) of 3 months. Compared with the best supportive care, chemotherapy improves the patient’s quality of life and may even prolong survival in squamous cell carcinoma [5, 6]. The EXTREME trial showed that the addition of Ce- tuximab to platinum-fluorouracil chemotherapy increased the median overall survival (from 7.4 to 10.1 months) compared with this doublet alone [2, 7]. Such data estab- lished the role of Cetuximab in first-line therapy for head and neck squamous cell carcinomas [8]. Several studies have shown the efficacy of taxanes— used as monotherapy or in combination with cisplatin or carboplatin—particularly when they were administered in metronomic scheduling, due to their antiangiogenic effect [9–11]. In a retrospective study of 60 patients, weekly Paclitaxel had partial responses in 43 % of the patients, median progression-free survival (PFS) of 6.2 months, and a median OS of 8.5 months [12]. Another chemotherapy regimen that has demonstrated benefit in these patients is the combination of Cetuximab A. E. Sosa Á J. J. Grau Á L. Feliz Á V. Pereira Á D. Alcaraz Department of Oncology, Hospital Clı ´nic de Barcelona, Villaroel 170, 08036 Barcelona, Spain C. Mun ˜oz-Garcı ´a Laboratory of Molecular Biology, University of Barcelona, Casanova 143, 08036 Barcelona, Spain M. Caballero (&) Department of Otorhinolaryngology, Hospital Clı ´nic de Barcelona, Instituto de Investigaciones Biome ´dicas Augusto Pi Sunyer (IDIBAPS), University of Barcelona, Villaroel 170, 08036 Barcelona, Spain e-mail: mcaba@clinic.ub.es 123 Eur Arch Otorhinolaryngol DOI 10.1007/s00405-013-2537-6