International Journal of Radiation Oncology * Biology * Physics
Volume 70, Issue 2 , Pages 391-395, 1 February 2008

Cetuximab With Concurrent Chemoradiation for Esophagogastric Cancer: Assessment of Toxicity

  • Howard Safran, M.D.

      Affiliations

    • Brown University Oncology Group, Providence, RI
    • Corresponding Author InformationReprint requests to: Howard Safran, M.D., Department of Medicine, The Miriam Hospital, 164 Summit Ave., Providence, RI 02906. Tel: (401) 793-7151; Fax: (401) 793-4049
  • ,
  • Mohan Suntharalingam, M.D.

      Affiliations

    • Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD
  • ,
  • Thomas Dipetrillo, M.D.

      Affiliations

    • Brown University Oncology Group, Providence, RI
  • ,
  • Thomas Ng, M.D.

      Affiliations

    • Brown University Oncology Group, Providence, RI
  • ,
  • L. Austin Doyle, M.D.

      Affiliations

    • Brown University Oncology Group, Providence, RI
    • University of Maryland Cancer Center, Baltimore, MD
  • ,
  • Mark Krasna, M.D.

      Affiliations

    • Department of Surgery, University of Maryland School of Medicine, Baltimore, MD
  • ,
  • Angela Plette, M.D.

      Affiliations

    • Brown University Oncology Group, Providence, RI
  • ,
  • Devon Evans, M.D.

      Affiliations

    • Brown University Oncology Group, Providence, RI
  • ,
  • Harold Wanebo, M.D.

      Affiliations

    • Brown University Oncology Group, Providence, RI
  • ,
  • Paul Akerman, M.D.

      Affiliations

    • Brown University Oncology Group, Providence, RI
  • ,
  • Jeremy Spector, M.D.

      Affiliations

    • Brown University Oncology Group, Providence, RI
  • ,
  • Nancy Kennedy, R.N., C.C.R.A.

      Affiliations

    • Brown University Oncology Group, Providence, RI
  • ,
  • Teresa Kennedy, R.N., C.C.R.A.

      Affiliations

    • Brown University Oncology Group, Providence, RI

Received 25 May 2007; received in revised form 3 July 2007; accepted 4 July 2007. published online 01 November 2007.

Purpose

To determine the feasibility and toxicity of the addition of cetuximab with paclitaxel, carboplatin, and radiation for patients with esophagogastric cancer on a Phase II study.

Methods and Materials

Patients with locoregional esophageal and proximal gastric cancer without distant organ metastases were eligible. All patients received cetuximab, paclitaxel, and carboplatin weekly for 6 weeks with 50.4 Gy radiation.

Results

Sixty patients were enrolled, 57 with esophageal cancer and 3 with gastric cancer. Forty-eight had adenocarcinoma and 12 had squamous cell cancer. Fourteen of 60 patients (23%) had Grade 3 dermatologic toxicity consisting of a painful, pruritic acneiform rash on the face outside of the radiation field. The rates of Grades 3 and 4 esophagitis were 12% and 3%, respectively. Three patients had Grade 3/4 cetuximab hypersensitivity reactions and were not assessable for response. Forty of 57 patients (70%) had a complete clinical response after chemoradiation.

Conclusion

Cetuximab can be safely administered with chemoradiation for esophageal cancer. Dermatologic toxicity and hypersensitivity reactions were associated with the addition of cetuximab. There was no increase in esophagitis or other radiation-enhanced toxicity.

Cetuximab, Esophageal cancer, Radiation

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 Presented in part at the 48th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO), November 5–9, 2006, Philadelphia, PA.

 Dr. Safran and Dr. Mohan report receiving grant support and honoraria from Bristol-Myers in the amount of less than $100,000. No other potential conflict of interest relevant to this article was reported.

PII: S0360-3016(07)03668-1

doi:10.1016/j.ijrobp.2007.07.2325

International Journal of Radiation Oncology * Biology * Physics
Volume 70, Issue 2 , Pages 391-395, 1 February 2008