How do you approach patients with metastatic SCC of the larynx, PD-L1 <1, unable to tolerate 5-FU based chemotherapy due to grade 4 esophagitis/mucositis?

Topics: Head and Neck Cancers • Medical Oncology

Answer from: Medical Oncologist at Academic Institution

For patients with PD-L1 zero metastatic head and neck squamous cell cancers, standard of care is platinum/5-FU/Pembrolizumab for first-line management. The mucositis from 5-FU can be very difficult for patients to tolerate, so if dose reductions do not meaningfully allow for tolerability, I switch t...

Comments

Medical Oncologist at Clinical Instructor
Thank you Dr. @Kedar Kirtane! What treatment would...

Medical Oncologist at University of Texas Health Science Center at Houston
Yes, it is usually single agents after that. Doce...

Answer from: Medical Oncologist at Academic Institution

Carbo-Taxol, Pembrolizumab (I tend to use even if PDL-1 <1%). Can also use carbo-Taxol-Cetuximab.

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