By Anne Harding

June 03, 2015

NEW YORK (Reuters Health) - In patients with cancer of the larynx or hypopharynx, adding docetaxel to induction chemotherapy with cisplatin and 5-fluorouracil significantly improved larynx preservation in a multicenter randomized trial.

Dr. Guillaume Janoray of the University Hospital of Tours, France and colleagues presented the findings June 1 in an afternoon oral abstract session at the American Society of Clinical Oncology's (ASCO) annual meeting in Chicago.

In the study, called GORTEC-2000-01, 213 patients with untreated stage III or IV invasive squamous cell carcinoma of the larynx or hypopharynx were randomly assigned to receive cisplatin (P) and 5-fluorouracil (F) with or without docetaxel (T), followed by radiation therapy for responders.

According to the researchers' abstract for the meeting, five- and 10-year larynx preservation rates were 74% and 70.3%, respectively, in patients who received all three drugs, versus 58.1% and 46.5% for the PF arm.

Five and 10-year rates of larynx dysfunction-free survival were 67.2% and 63.7%, respectively, for the TPF arm, versus 46.5% and 37.2% for the patients who received PF.

There were no differences between the two groups in overall survival, disease-free survival, or locoregional control rates. However, the rate of grade 3-4 late toxicities was lower for the TPF patients (9.3% vs 17.1%; p=0.038).

"That combination regimen is more aggressive, but not necessarily more toxic," Dr. Gregory Masters, an ASCO spokesman and chairman of the ASCO Cancer Communications Committee and a medical oncologist at the Helen F. Graham Cancer Center in Delaware, told Reuters Health in a telephone interview.

Toxicity was lower, he added, because using docetaxel allowed the investigators to reduce dosage of the other two drugs. "In every way, the study showed that TPF is superior," he added. "It improved overall function and quality of life by lessening the chance of having to go through a major incapacitating surgery."

Other approaches to treating laryngeal cancer involve giving radiation and chemotherapy simultaneously, Dr. Masters noted, while some patients will need to go directly to surgery.

New research has shown that more targeted treatment, as well as immunotherapy, offer promise for treating laryngeal cancer, he added.

"Part of our job now is continuing to move forward. We've established right now the best chemotherapy, the next question is can we tweak that," he said.

Dr. Janoray did not respond to a request for comment by deadline.


Am Soc Clin Oncol 2015.


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