Researchers at the Wayne State University School of Medicine and the Barbara Ann Karmanos Cancer Institute recently presented data demonstrating the feasibility of long-term, low-dose adjuvant chemotherapy, which resulted in fewer tumor recurrences and cancer metastases in patients with locally advanced head and neck squamous cell carcinoma. The findings were announced at the 2009 American Society of Clinical Oncology Annual Meeting in Orlando, Fla.

The researchers discovered that when they utilized oral chemotherapy agent capecitabine, also known by its pharmaceutical name Xeloda, on 35 study patients over approximately 36 months, the survival rate for 97 percent of those patients was two years and the three-year progression-free survival rate was 86 percent.

The research was supervised by George Yoo, M.D., F.A.C.S., associate professor of the Department of Otolaryngology-Head & Neck Surgery and Oncology for the School of Medicine. Dr. Yoo also serves as the chief medical officer and member of the Head and Neck Cancer Multidisciplinary Team at Karmanos. Ammar Sukari, M.D., assistant professor of Medicine for the School of Medicine and fellow member of the Head and Neck Cancer Multidisciplinary Team, conducted the poster presentation.

“What the study found is that low-dose, long-term adjuvant therapy is feasible,” said Dr. Yoo. “We are pleased with the results. There was a relatively low recurrence rate for the tumors.”

Approximately 40,000 new cases of head and neck squamous cell carcinoma (HNSCC) cases are diagnosed each year, Dr. Yoo said. A higher proportion of men are diagnosed with carcinomas -- approximately four to one as compared to women. Chemotherapy for HNSCC is typically rigorous and even then 40 percent to 60 percent of patients experience recurring carcinoma tumors. The survival rate for advanced HNSCC is less than 40 percent.

The exploration of low-dose, long-term oral chemotherapy agents in adjuvant (i.e. follow-up) cancer treatment represents new and exciting territory for scientists. Capecitabine was the first FDA-approved oral chemotherapy treatment, gaining approval for human use in 1998. Since then, other oral cancer agents have been developed, including Tamoxifen for breast cancer patients and Methotrexate, which is used to treat breast, skin, head, neck and lung cancers.

“There are not many low-dose applications for oral chemotherapy,” Dr. Yoo said. “Intravenous chemotherapy is still the norm. From the innovation standpoint, it’s really a new way of looking at chemotherapy.”

The study is investigator-initiated in which researchers worked with capecitabine’s manufacturer Roche to perform the study. Dr. Yoo said Karmanos continues to enroll patients in the Phase II study and hopes that the study will enter a third phase.

“We thought it was a good study, one that explores the effects of low-dose, long-term oral chemotherapy treatments,” said Dr. Yoo. He added that not only does low-dose, long-term adjuvant therapy for HNSCC patients promise longer survival and lower recurrence of tumors, it’s an easy treatment method, with minimum side effects, and one that would ensure all patients could undergo adjuvant therapy.