Docetaxel for head and neck cancer

There have been two main studies to date supporting its use in this indication. TAX 323 involved 358 patients with locally advanced (stage III-IV) unresectable SCCHN, where the addition of docetaxel (T) to the standard PF (cisplatin and 5-FU) induction regimen followed by radiotherapy was found to increase the median progression-free survival from 8.2 months to 11.0 months (HR 0.72, 95% CI 0.57-0.91, p=0.007) and overall survival from 14.5 months to 18.8 months (HR 0.73, 0.56-0.94, p=0.02). TAX 324 found that the addition of T to standard PF induction followed by concurrent chemoradiotherapy increased median overall survival from 30 months to 71 months (HR 0.70, 0.54-0.90, p=0.006) and median progression-free survival from 13 months to 36 months (HR 0.71, 0.56-0.90, p=0.004) in a similar group of patients, however it also included those who had resectable disease. The main difference between the two trials was the use of subsequent concurrent chemoradiotherapy in TAX 324 versus radiotherapy alone in TAX 323; the former is of more relevance to practice as chemoradiotherapy is the current standard of care in the UK.