Photo of Jochen H Lorch,  MD, MSc

Jochen H Lorch, MD, MSc

Dana-Farber Cancer Institute

Dana-Farber Cancer Institute
Phone: (617) 632-3090
Fax: (617) 632-4448


Jochen_Lorch@dfci.harvard.edu

Jochen H Lorch, MD, MSc

Dana-Farber Cancer Institute

EDUCATIONAL TITLES

  • Assistant Professor, Medicine, Harvard Medical School
  • MD, Medical Oncology, Dana-Farber Cancer Institute

Research Abstract

Long term (Five-year) results of Tax324: A Phase III Trial of Sequential Therapy comparing TPF with PF in Patients with locally advanced squamous cell cancer of the head and neck

Background: In the original TAX324 report, after a minimum follow up of two years and a median of 42 months, sequential chemotherapy with Taxotere, cisplatin and 5FU (TPF) significantly improved survival by 30% compared with cisplatin and 5FU (PF). TAX324 and TAX 323 established Induction and Sequential therapy with TPF as treatment standards for patients with Locally Advanced Head and Neck Cancer (LAHNC). We are now presenting the long term results of the TAX324 study.

Material and Methods: After IRB approval, the study group used the anonymous study codes of the patients who were alive or lost to follow up in the 2005 analysis to gather current data from the study sites. With a minimum follow up through December 1, 2008, data on survival, progression free survival and other factors were gathered and analyzed by summary statistics.

Results: The initial demographics, therapy and toxicity were previously reported. Data of 85% of 501 subjects randomized to either TPF or PF treatment on TAX 324 was collected. With a median follow up of 71 months and a minimum of 5 years, the overall survival in the TPF group was significantly longer than in the PF group (HR 0.74; 95% CI 0.58-0.94; p=0.013). Median survival was 71 and 30 months respectively, and mortality was reduced 24% in the TPF arm compared with PF. At 5 years 52% and 42% of the TPF and PF patients are alive (p=0.06). Subset analysis showed that the median survival was improved across all sites with TPF. Median survival was not reached in patients with oropharyngeal tumor locations who were treated with TPF while it was 68 months in the PF group (HR 0.71, 95% CI 0.5-1.97; p=0.07). The complete data set including the rate of tracheostomy and enteral feeding tube dependence among survivors will be presented at the meeting.

Conclusion: The benefit of induction chemotherapy with TPF is significantly superior to PF beyond 5 years and has been maintained at essentially the same level of impact as in the 2 year follow up. These data support the long term efficacy of TPF and sequential therapy in the management of appropriate patients with locally advanced head and neck cancer.

 

Publications

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  • Li YY, Hanna GJ, Laga AC, Haddad RI, Lorch JH, Hammerman PS. Genomic analysis of metastatic cutaneous squamous cell carcinoma. Clin Cancer Res 2015; 21:1447-56. PubMed
  • Guze K, Pawluk HC, Short M, Zeng H, Lorch J, Norris C, Sonis S. Pilot study: Raman spectroscopy in differentiating premalignant and malignant oral lesions from normal mucosa and benign lesions in humans. Head Neck 2014. PubMed
  • Haddad R, O'Neill A, Rabinowits G, Tishler R, Khuri F, Adkins D, Clark J, Sarlis N, Lorch J, Beitler JJ, Limaye S, Riley S, Posner M. Induction chemotherapy followed by concurrent chemoradiotherapy (sequential chemoradiotherapy) versus concurrent chemoradiotherapy alone in locally advanced head and neck cancer (PARADIGM): a randomised phase 3 trial. Lancet Oncol 2013; 14:257-64. PubMed
  • Hanna GJ, Haddad RI, Lorch JH. Induction chemotherapy for locoregionally advanced head and neck cancer: past, present, future? Oncologist 2013; 18:288-93. PubMed
  • Limaye SA, Posner MR, Krane JF, Fonfria M, Lorch JH, Dillon DA, Shreenivas AV, Tishler RB, Haddad RI. Trastuzumab for the treatment of salivary duct carcinoma. Oncologist 2013; 18:294-300. PubMed
  • Lin CI, Whang EE, Lorch JH, Ruan DT. Autophagic activation potentiates the antiproliferative effects of tyrosine kinase inhibitors in medullary thyroid cancer. Surgery 2012; 152:1142-9. PubMed
  • Lorch JH, Goloubeva O, Haddad RI, Cullen K, Sarlis N, Tishler R, Tan M, Fasciano J, Sammartino DE, Posner MR, . Induction chemotherapy with cisplatin and fluorouracil alone or in combination with docetaxel in locally advanced squamous-cell cancer of the head and neck: long-term results of the TAX 324 randomised phase 3 trial. Lancet Oncol 2011; 12:153-9. PubMed
  • Lin CI, Whang EE, Donner DB, Du J, Lorch J, He F, Jiang X, Price BD, Moore FD, Ruan DT. Autophagy induction with RAD001 enhances chemosensitivity and radiosensitivity through Met inhibition in papillary thyroid cancer. Mol Cancer Res 2010; 8:1217-26. PubMed
  • Haddad RI, Tishler RB, Norris C, Goguen L, Balboni TA, Costello R, Wirth L, Lorch J, Andreozzi B, Annino D, Posner MR. Phase I study of C-TPF in patients with locally advanced squamous cell carcinoma of the head and neck. J Clin Oncol 2009; 27:4448-53. PubMed
  • Settle K, Posner MR, Schumaker LM, Tan M, Suntharalingam M, Goloubeva O, Strome SE, Haddad RI, Patel SS, Cambell EV, Sarlis N, Lorch J, Cullen KJ. Racial survival disparity in head and neck cancer results from low prevalence of human papillomavirus infection in black oropharyngeal cancer patients. Cancer Prev Res (Phila Pa) 2009; 2:776-81. PubMed
  • Lorch JH,Posner MR,Wirth LJ,Haddad RI. Seeking alternative biological therapies: the future of targeted molecular treatment. Oral Oncol 2008; 45:447-53. PubMed
  • Lorch JH,Posner MR,Wirth LJ,Haddad RI. Induction chemotherapy in locally advanced head and neck cancer: a new standard of care? Hematol Oncol Clin North Am 2008; 22:1155-63, viii. PubMed
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