David,

I'm confused. The purpose of cisplatin and other platinum-based drugs is completely different than the purpose of Erbitux, and as such, I was given both, cisplatin to make the cancer cells more susceptible to radiation and the Eribtux to prevent the cells from dividing. Both mechanisms were used since I was Stage IV with effusion.

Not a chemo expert but I am repeating what my RO told me word for word and he is one of the doctors sponsoring, if that's the right word, the study using Erbitux instead of Cisplatin on only HPV+ patients. The study approving group rejected his study using a lower amount of rads on HPV+ patients but did approve this study.

Well I hope that the patients in your RO's study who just get Erbitux rather than a combo of Erbitux and cisplatin/carboplatin fare better than I did as a HPV+ patient. What's interesting about Erbitux is that it was initially approved for colo rectal cancer and then they discovered that it just doesn't work on about 35% of patients with a version of the KRAS gene which interferes with the EGFR action of Erbitux. In fact, assessment for EGFR expression and KRAS mutation is standard good medical practice for the use of cetuximab (Erbitux) in Colorectal Cancer, but not required for use in Head & Neck Cancer.
There is increasing evidence to support the use of such biomarkers in predicting tumor response to treatment, as this allows therapeutic approaches to be tailored or personalized to individual patients and results in improved outcomes and survival. Unfortunately I haven't heard of anyone exploring screening head and neck cancer patients to see if Erbitux would actually work on them. My RO mentioned not much drug company funding available on showing a major money maker doesn't work as well as they thought on over a third of patients.
Charm

The trial I am entering is RTOG 0920. No stipulations about HPV + or -, they take anyone and assess HPV status to see if it alters effectiveness.

The way I see it it is another arrow in the quiver.
Radiation damages your DNA and the idea is that cancer cells with their faster metabolism and growth get damaged more and decide to die (apoptosis). Cisplatin damages (cross links) your DNA and also screws up DNA repair, but it does so systemically. If you apply both, cisplatin enhances the effect in the radiated region, but also has some long distance effect. Erbitux targets the grow factor receptor (EGFR), which is SOME cancers is overexpressed and susceptible to the Erbitux (antibody). So the mechanism is different from cisplatin but since you also weaken the susceptible cells in the radiation field I would also expect some synergism. What would be interesting is to have statistics/data on a concurrent regimen of radiation, Erbitux (if biomarker present) AND cis or carboplatin. Perhaps this could allow you to lower dosages or rads.....

M

Well said Markus. I don't regret my Erbitux even though it geometrically increased my radiation dermatitis, but it's a question of 20/20 hindsight. After the same tumor came back, my RO concluded that it was Erbitux resistant. My frustration is that they have not developed a test for head and neck tumors similar to the KRAS gene test for colo rectal cancer so in effect an Erbitux only regime for OCF patients is a crap shoot. At the time of my treatment however, all the studies indicated it was a viable option and even the FDA said so. Too wise too late.
Charm

According to my Dr T the "study approving people" were totally against decreasing the greys even in HPV+ where, if one were going to try to reduce the effects of radiation and still have a chance to kill the cancer, that's where I would want to start.

Hey everyone. Thanks for all the information again. It is truely appreciated. I do have another question. When you had the acne was it itchy and what did you do for it? My sisters is very iitchy. She is happy she has it though the dr's told her that means it's working. Hope everyone has a great day!

I didn't and don't have HPV but sure did have Erbitux. I wish I would have had HPV LOL or at least get a name for the cause of my OC. I hate the sound of cause unknown but would like a fancy word or letters to toss around. LOL Hell, I am alive and being good old goofy Jim yet.

Jim,

Chances are very good that you acquired HPV numerous times in your life but your immune system was better at dealing with it than those of us that kept it around long enough to let it get us into trouble so you should slap your immune system on it's back and tell it "job well done munney!!" lol