Sally
Long Answer: I am so glad that Brian weighed in here as I am so biased against
Erbitux that I cannot be objective in my advice. Plus I am not a doctor and am not licensed to practice medicine only law. Brian on the other hand can be objective and has given you excellent advice.
As to your question,the implication of the quote I posted is that
HPV negative patients did better with
Erbitux.
Now that you mentioned PNI, relying upon
Erbitux alone seems rather risky to me. I did and my cancer did come back.
Meanwhile, many others here had cisplatin or carboplatin and their cancer did not come back. Simplistic, yes, non-probative, definitely, True nevertheless.
Some studies show good results with using BOTH a platinum based chemo like cisplatin or carboplatin and
Erbitux.
When you talk with the MO, it could not hurt to ask if has considered the possibility that there could be a KRAS type gene issue for
Erbitux for oral cancer (The KRAS gene encodes a small G protein on the EGFR pathway. Cetuximab or
Erbitux and other EGFR inhibitors only work on tumors that are not mutated) Since 40% of all colo-rectal patients have this mutated gene,
Erbitux literally cannot work for them
My MO is actually doing a clinical study to see if he can find a similar gene issue, perhaps not KRAS but one nonetheless, for head and neck cancer. He was stunned when
Erbitux failed me so badly and is trying to understand why. Unfortunately, so far they have no test to see for whom
Erbitux works, except after the fact when it's a little too late for the patient. After they found PNI in my recurrence, my MO switched me to carboplatin. so far, so good.
Why take a chance that you are part of the unlucky percentage that
Erbitux does not work on?
Don't mean to scare you, but IMO this is a case of better safe than sorry.
Short Answer:
Erbitux is like that little girl with the curl in the middle of her forehead: When it is good, it is very very good, and when it is bad, it is horrid.
Charm