Patients suffering from head and neck cancer often find the drug cisplatin toxic. In a first study, published in American Society’s Journal of Clinical Oncology, researchers from Tata Memorial Hospital Centre have found a significant improvement in disease control after patients used Docetaxel along with radiation.
“Docetaxel is a chemotherapy medicine with a potential to increase the effect of radiation,” says Dr Kumar Prabhash, lead researcher of the study.
Head and Neck cancers are the most common cancers in India. Almost 60-70% of these cancers are caught in locally advanced stages. These patients require chemotherapy with radiotherapy.
“Around 2.5 lakh new cases of head and neck cancer are diagnosed every year in India. Most of them are in advanced stages and require a therapeutic regimen of chemo radiation with the drug Cisplatin. When administered together with radiotherapy, cisplatin-based chemotherapy improves local–regional control and overall survival of patients due to its properties as a radio-sensitiser. However, about 30-40% of patients cannot take cisplatin due to its systemic toxicities,” says Dr Kumar Prabhash, professor, medical oncology, Tata Memorial Hospital.
Study to develop alternative treatment
There is a considerable unmet clinical need for alternative treatment for this patient population. This has led to the study to develop another option which is more feasible to administer in these patients. A new study that compared radiotherapy to radiotherapy with chemotherapy (docetaxel) in these patients was led by Dr Vanita Noronha, Dr Vijay Patil, Dr Kumar Prabhash under the leadership of Dr RA Badwe at Tata Memorial Hospital. Around 356 adult patients with locally advanced head and neck squamous cell carcinoma were recruited between July 2017 and May 2021. These patients were among those who could not tolerate cisplatin drugs.
The primary end point was two-year disease-free survival (DFS), says Dr Kumar Prabhash, lead researcher, who added that this was the first study to show improvement in patients’ outcome. Patients receiving docetaxel based treatment saw a significant improvement in disease control. Overall survival also improved with the addition of docetaxel with almost 30 per cent relative decrease in deaths of patients receiving this treatment.
Although the addition of docetaxel to radiotherapy resulted in a significant increase in grade 3/grade 4 toxicities including mucositis, odynophagia and dysphagia, it was manageable. Patients treated with docetaxel reported better quality of life as compared with those who received radiotherapy alone.
“This is also very cost effective as the total cost of chemotherapy is around Rs 5,000 and is also within limits of all government schemes,” Dr Vijay Patil adds.
The Indian Cancer Genome Atlas ICGA is a long-term collaborative effort to facilitate precision medicine and improve translational cancer research in India.