Comparative Evaluation of Radiotherapy with Concurrent Weekly Cisplatin versus Concurrent Daily Erlotinib and Weekly Cisplatin in Locally Advanced Carcinoma Cervix
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 5, Issue 10
Abstract
Background: Erlotinib is an oral epidermal growth factor receptor tyrosine kinase inhibitor. Early phase clinical trials of Erlotinib in combination with cisplatin-based concurrent chemoradiotherapy (CCRT) in locally advanced carcinoma cervix have demonstrated improved antitumor responses with mild toxicity profile; however, the evidence available on this is limited. We prospectively evaluated the efficacy and safety of Erlotinib (150 mg/day) with CCRT in locally advanced carcinoma cervix and compared with standard CRT. Materials and Methods: In this prospective, comparative study, 60 locally advanced carcinoma cervix patients received either Erlotinib (150 mg/day) with CRT or CRT. Treatment CRT included cisplatin 40 mg/m2 intravenously weekly concurrently with external beam radiation followed by intracavitary brachytherapy. Tumor response was calculated as per the WHO criteria. Toxicity and adverse events (AEs) were assessed as per CTCAE v 3. Results: The higher number of patients achieved a complete response in the Erlotinib plus CRT group than the CRT group (28/30, 93.3% vs. 21/30, 70%, P < 0.05), which was statistically significant. The AEs commonly encountered in both the treatment groups were majority of Grade 1/2. A higher incidence of diarrhea and skin reaction was noted in the Erlotinib plus CRT group in comparison CRT, whereas the incidence of nausea and vomiting was higher in the CRT group. No Grades 4 and 5 toxicity was observed in Erlotinib with CRT. Erlotinib was observed to be safe with manageable toxicity profile. Conclusion: Erlotinib 150 mg daily can be safely added to cisplatin-based CCRT in locally advanced carcinoma cervix, to achieve better therapeutic response without potentiating the toxicity
Authors and Affiliations
Shyamji Rawat, M K Advait, Pranjil Mandloi
Keywords
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