Cetuximab in Locoregionally Advanced Head and Neck Cancer: A Real-World Case Series

Background: Management of locoregionally advanced squamous cell carcinoma of the head and neck (LASCCHN) has evolved from primarily surgical approaches to radiotherapy (RT) -based regimens. Randomized trials have shown that adding cetuximab to RT or chemotherapy improves 5 -year overall survival (OS) in LASCCHN. However, real -world data remain limited. Methods: This retrospective study analyzed 20 patients with non -metastatic LASCCHN treated with cetuximab -based regimens at our institution between April 2015 and July 2023. Patients received cetuximab either concurrently with RT or with chemotherapy (CT). Outcomes assessed included OS, progression -free survival (PFS), overall response rate (ORR), disease control rate (DCR), and treatment -related toxicities. Results: The median age was 60 years (range 54-87); 80% were male. Half had an ECOG performance status of I, and half had II. Ten percent had multiple comorbidities. Cetuximab was used as 1st -line treatment in 70%, 2nd -line in 15%, 3rd -line in 5%, and 4th -line in 10% of patients. Eleven patients (55%) received cetuximab with RT, while the rest received it with CT. Median followup was 24 months. Median OS was 40 months (95% CI: 18-61.9), and median PFS was 4 months (95% CI: 0-12.7). Notably, OS was significantly higher in patients receiving cetuximab with RT (median OS 65 months; 95% CI: 27.8-102) compared to those receiving it with CT alone (median OS 21 months; 95% CI: 0-44.3; p = 0.04). ORR was 65%, and DCR was 75%. Grade 3 toxicities were observed in 30% of patients (fatigue), 15% (rash), 10% (hypersensitivity reactions), and 5% (combined rash and fatigue). No treatment -related mortality was reported. Conclusion: Cetuximab is well tolerated in Indian patients with LASCCHN and appears to provide a survival benefit, especially when used concurrently with radiotherapy. Further prospective studies are warranted to validate these real -world findings.