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Technical Report
Intra-arterial cetuximab for the treatment of recurrent unresectable head and neck squamous cell carcinoma
Tristan Tham, Timothy G. White2, Shamik Chakraborty, Rohan R. Lall, Rafael Ortiz,, David J. Langer, Deborah Shatzkes, Christopher G. Filippi, Dennis Kraus, John A. Boockvar and Peter D. Costantino

Importance: Management of recurrent head and neck squamous cell carcinoma is a common and challenging clinical problem in head and neck oncology.

Objective: Here we present the first reported case of super-selective intra-arterial (SSIA) microcatheter based local delivery of cetuximab for head and neck cancer. This technical report describes the techniques used to deliver the SSIA dose of cetuximab, as well as the patient outcome.

Design: This technical report is part of an ongoing Phase I Clinical Trial

Setting: The New York Head and Neck Institute (NYHNI) is a full-service otolaryngology and neurosurgery department at Lenox Hill Hospital, part of the Northwell Health System. The NYHNI serves a diverse patient population with a wide range of head and neck diseases in a tertiary hospital setting.

Intervention: SSIA Cetuximab

Participant: A patient presents to our clinic with recurrent unresectable squamous cell carcinoma of the nasopharynx. He is recruited into the first cohort of a phase I clinical trial to assess the safety of SSIA cetuximab, dose starting at 100mg/m2. Adjuvant chemoradiation therapy is also given.

Main Outcome(s) and Measures: Safety, as measured by toxicity of SSIA cetuximab.

Results: SSIA Cetuximab has been demonstrated to be a safe and feasible procedure in this technical report.

Conclusions and Relevance: This case illustrates technical feasibility and a very preliminary assessment of the safety of a novel delivery of a biologic agent for squamous cell carcinoma of the head and neck, which is part of an ongoing phase I clinical trial.

Trial Registration: NCT02438995

Keywords: Intra-arterial, head and neck cancer, nasopharyngeal cancer, squamous cell carcinoma, cetuximab, recurrent squamous cell carcinoma, Phase I clinical trial

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