Pharmacodynamic trial of nimotuzumab in unresectable squamous cell carcinoma of the head and neck: A SENDO Foundation study

Federico Rojo, Elías Gracias, Nadia Villena, Teresa Cruz, Josep Maria Corominas, Irene Corradino, Mercedes Cedeño, Clara Campas, Marta Osorio, Normando Iznaga, Beatriz Bellosillo, Ana Rovira, Silvia Marsoni, Pere Gascon, Sergio Serrano, Cristiana Sessa, Tania Crombet, Joan Albanell

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54 Citations (Scopus)

Abstract

Purpose: To assess the pharmacodynamic effects of nimotuzumab, an anti-epidermal growth factor receptor (EGFR) monoclonal antibody with intermediate affinity for the receptor, in skin and tumor tissues from head and neck cancer patients. Experimental design: Pharmacodynamic study in patients with advanced squamous cell carcinoma of the head and neck, unsuitable for chemoradiotherapy, enrolled in a single-center trial. Patients received 8 weekly infusions of nimotuzumab. The first nimotuzumab infusion was administered 1 week before starting radiation, whereas the remaining doses were administered concomitantly with irradiation. Paired biopsies were taken from skin and primary tumors, before (pretherapy) and 1 week (on single-agent therapy) after first infusion. Immunohistochemistry was conducted to assay the effects of nimotuzumab on total and phosphorylated EGFR, phosphorylated extracellular signal-regulated kinase 1/2 (p-ERK1/2), p-AKT, and proliferation (Ki-67). Results: Nimotuzumab was well tolerated and there was no evidence of skin rash. Objective response was achieved in 9 of 10 patients. The pharmacodynamic assays showed inhibition of p-EGFR in both skin and tumor (P = 0.042 in skin and P = 0.034 in tumor). No significant changes in p-ERK1/2, p-AKT, or Ki-67 were detected in skin. In addition, lymphocytic infiltrates, folliculitis, or perifolliculitis were not observed. In tumor samples, there was an upregulation of p-AKT (P = 0.043), a reduction in proliferation index (P = 0.012), and a nonsignificant trend toward a decrease of p-ERK1/2 (P = 0.091). Conclusions: The pharmacodynamic data confirmed the ability of nimotuzumab to decrease EGFR phosphorylation. Downstream effects were observed in tumor cells but not in skin, a finding that may help to explain the lack of skin rash in patients treated with nimotuzumab. ©2010 AACR.
Original languageEnglish
Pages (from-to)2474-2482
JournalClinical Cancer Research
Volume16
Issue number8
DOIs
Publication statusPublished - 15 Apr 2010

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