TITLE:
Treatment Outcome of Pharmacokinetics-Based Dosing of Docetaxel and Fluorouracil in Advanced Head and Neck Cancer Patients
AUTHORS:
Abdelhamid M. Fouad, Magdy M. Saber, Yahia M. Ismail, Yasser A. Sallam, Tarek M. Shouman, Reham A. A. Elshimy, Ahmed Abo Gabal
KEYWORDS:
Head and Neck Cancer, DPF, Docetaxel, Fluorouracil, Pharmacokinetics Dose Adjustment
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.9 No.12,
December
18,
2018
ABSTRACT: Introduction: Docetaxel, Cisplatin and 5-Fluorouracil (DPF) became the standard induction chemotherapy in advanced Head
and Neck Cancer (HNC) but associated with high toxicity rate. Several
studies reported higher response rates with better tolerability when
chemotherapy dose is calculated based on Pharmacokinetics (PK) versus
conventional Body Surface Area (BSA). Patients and Methods: Thirty nine
patients with stage III and IV HNC who received induction DPF were included in
the study. Dose of cycle 1 was BSA-based then Docetaxel and 5-FU doses were
PK-adjusted starting from cycle 2 whereas Cisplatin dose was BSA-based
throughout the study. Results: After median follow up period of 14
months the median overall survival (OS) and progression free survival (PFS)
were 15.1 and 10.6 months respectively. Twenty nine patients were available for
response assessment. Seven patients (24.1%) achieved complete response while
partial response encountered in 19 patients (65.5%) with and Overall response
rate of 89.6%. Both treatment related side effects and mortality significantly
decreased after the application of PK dose adjustments (p-value 0.007 and 0.01
respectively). Conclusion: PK-guided dose adjustments of 5-FU and
Docetaxel in DPF regimen can significantly decrease the treatment related side
effects and mortality without compromising the tumor response rate. A
randomized clinical trial is needed to compare the PK-guided dose adjustment
with the standard BSA based protocol.