1001PEFFICACY AND TOXICITY OF GEFITINIB IN PALLIATIVE TREATMENT IN RECURRENT SQUAMOUS CELL CARCINOMA OF HEAD AND NECK IN POOR PERFORMANCE ELDERLY PATIENTS

ABSTRACT Aim: Head and neck carcinoma is the most common malignancy accounting for almost 55% of the total presenting cases in India. Most of the patients are in locally advanced stage where platinum-based concurrent chemo radiotherapy is the treatment of choice; however, 30-40% of patients show recurrence in follow up. When salvage surgery is not feasible chemotherapy is offered; however, elderly patients with poor performance have very limited options available. Oral gefitinib is considered in such category of patients. Methods: We enrolled 100 patients with recurrent squamous cell carcinoma of head and neck from June 2012 to June 2013. Eligibility criteria: included patients must have minimum age of 65 years, ECOG performance status 3-4, have received previous concurrent chemoradiotherapy and be ineligible for any salvage surgery or injectable chemotherapy. The median age at presentation was 64 years and 76 patients were male. All these patients were then kept on oral gefitinib at a daily dose of 250 mg. The clinical response rate, disease control rate (complete response, partial response, stable disease), time to progression (TTP), survival and toxicity were studied. Results: The clinical response rate was 14% with a disease control rate (complete response, partial response, stable disease) of 45%. In all, 55% of patients experienced an improvement in their symptoms. The median TTP and survival were 5.3 and 10.6 months, respectively. Acneiform folliculitis was the most frequent toxicity observed (24%) but the majority of cases were grade 1 or 2 followed by diarrhea (16%). Conclusions: Treatment options for recurrent progressive head and neck cancer in poor performance status elderly patients are limited and therefore this is an area of high unmet need. Oral gefitinib is a good option in such category of patients as compliance is good being an oral formulation and toxicity profile is manageable. Gefitinib was well tolerated and yielded symptomatic improvement in more than half of patients. Disclosure: All authors have declared no conflicts of interest.