Cisplatin based treatment is still the standard with radiation for first line treatment with oropharyngeal SCC, according to NCCN guidelines, so that includes Carbopatin, which I had also, but Cisplstin is preferred.

Erbitux was initially used for colorectal cancer back in the early 80's, the drug company had some problems approving by the FDA, and if you recall, Martha Stewart went to jail when everyone was dumping their stocks. Anyway, it was approved, new drug company too. and in 2006 was approved for HNC for recurrent and metatastic cancer. Then around 2011 it was approved for first line treatment in HNC, but still Cisplatin is preferred outside clinical trials.

There was plenty of discussions here about Erbitux a few years ago. It was
popular then, but I don't know of many that are having it recently as first line treatment for their initial cancer treatment, unless it was with induction chemo, after induction as concurrent treatment, maintenance chemo or palliative care. A few I know, including myself, had recurrences after Erbitux, but that can happen with other type treatments too, but makes you notice more after hearing negativity,

Erbitux doesn't work in 5% head and neck cancers, from what I heard. For colorectal cancer it doesn't work in about 40% of patients, but they have an assay that checks to see if they have the wild-type KRAS gene, which it works with. If not, they may not get the treatment. For head and neck cancers this tedt isn't used or works. They have or are still working on a drug that helps with Erbitux, a monoclonal antibidy, drug resistance.

There was an article from MSKCC to the Journal of Clinical Oncology a few years back, about holding off on replacing Cisplatin with Erbitux since it had some disappointing results, and the trial comparing it to Cisplatin wasn't completed yet.

I had Erbitux, also with Taxotere, and yes, it was easier than TPF Induction Chemo, but is not without side effects, which include the notorious rash, as mentioned, itching, which is an indicator it working, but not always, itching, low red blood counts, hand and foot syndrome, conjunctivitis, etc. I also had weekly Carboplatin, and that was easiest of them all, at least for me. No chemo or targeted therapy has no side effects, they all do.

Erbitux is usually given by a loading dose of 400mg, the first week, and 250mg every week thereafter, along with Benadryl, to help reduce allergic reaction, which is also a concern with the initial infusion, along with heart attack, in rare cases, so they monitor you closely the 1st and 2nd week when they mostly occur, and one should let them know right away of anything unusual.

You don't mention HPV positivity, which would be beneficial with oropharyngeal cancer, but doesn't sound like it is due to the extent of the cancer? I heard Erbitux should only be considered with HPV, but could be wrong.

Good luck, and welcome.


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs