Taxoids in head and neck cancer: the American approach

The taxoids docetaxel and paclitaxel entered into clinical trials in the 1980s. Paclitaxel has dominated clinical investigations in the United States while docetaxel gained a foothold early in Europe. Now both agents are under intensive study in both countries. The Eastern Cooperative Oncology Group (ECOG) conducted a series of paclitaxel trials in patients with recurrent or metastatic squamous cell head and neck. The current study directly compares paclitaxel + cisplatin to cisplatin + 5-FU. Similarly, an international trial is in progress directly comparing docetaxel-based chemotherapy to cisplatin + 5-FU. For patients with locally advanced disease, phase I-II trials evaluating various doses and schedules of paclitaxel or docetaxel administered concurrently with radiotherapy are in progress or recently reported in preliminary form. No one regimen is clearly preferred. The results of selected studies and trials in progress in the United States are reviewed.