TPFE (docetaxel, cisplatin, 5-FU and cetuximab) for recurrent mucoepidermoid carcinoma of the parotid gland: an aggressive strategy for an aggressive disease

BJMO - volume 11, issue 8, december 2017

A.R. Garcia MD, C. van Laer MD, D. van den Weyngaert , T. van den Wyngaert , M. Lammens MD, PhD, P. Specenier MD, PhD, J.B. Vermorken MD, PhD


The prognosis of patients with advanced malignant salivary gland cancer is usually poor. Systemic therapy combined with best supportive care is recommended for patients with metastatic or recurrent advanced salivary gland cancer ineligible for surgery or radiotherapy. Sensitivity to chemotherapy is thought to be histotype specific. However, to date, none of the systemic therapies, whether cytotoxic or non cytotoxic, can be considered standard for these tumours.

We report the case of a 43 year-old male patient with a third (loco)regional recurrence and metastases in lymph nodes below the clavicles of a mucoepidermoid carcinoma of the right parotid gland. He participated in a feasibility study and was treated with 3-weekly cycles of docetaxel, cisplatin, 5-fluorouracil plus weekly cetuximab (TPFE). After four TPFE cycles, additional radiation was given to the left neck. A complete response was reached which is ongoing for ten years. TPFE induced acute toxicities: skin rash grade 3, hypotension grade 3, neutropenia grade 3, anaemia grade 2 and alopecia grade 2. This observation underlines the importance of offering patients the possibility to participate in clinical trials. International collaboration for rare head and neck cancers, such as mucoepidermoid carcinoma, is urgently needed.

(BELG J MED ONCOL 2017;11(8):386-392)

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