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Do you offer induction chemotherapy for patients with cT4N0 laryngeal cancer who decline surgery and are not candidates for high dose cisplatin-based concurrent RT?

NCCN suggests either concurrent chemoRT or induction chemotherapy in these patients.
4 Answers
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Medical Oncology · Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
Answered on

any curative intent treatment with cisplatin would be high dose. are they not candidates for cisplatin or RT?

If renal issues and not candidates for cisplatin, would go with carbo/taxol or cetuximab with definitve RT

If not candidate for RT, would go with palliative intent chemo+immunotherapy

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Medical Oncology · Florida Cancer Specialists
Answered on · Updated on

The main benefit of Induction chemotherapy is improvement of distant failures, therefore it’s a reasonable alternative to CRT for Hypopharynx, and other sites with N3 disease. For a T4N0 Larynx the main problem is local control (besides the functional problem of course), therefore I do not believe i...

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Medical Oncology · University of Texas MD Anderson Cancer Center
Answered on

The best option is concurrent radiotherapy + chemotherapy (CRT). I agree with options for non-cisplatin concurrent as per Dr. Seetharamu.

Induction chemotherapy followed by radiotherapy alone (if unable to tolerate CRT) is also reasonable.

It is not standard of care, but if the CPS score for PDL1 is...

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Medical Oncology · Utica Park Clinic
Answered on · Updated on

I agree with trying as much as possible to do concurrent chemo rad.

I am pleasantly surprised by inferiority of cetuximab to cisplatin concurrently in the most recent data. I wonder if it’s because they can’t take cisplatin due to risk of neutropenia or renal failure.

Food for thought -- has anyone...

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