Ibero-American Expert Consensus on Squamous Cell Carcinoma of the Head and Neck Treatment in Patients Unable to Receive Cisplatin: Recommendations for Clinical Practice

Agustín Falco,1 Thiago Bueno de Oliveira,2 Jon Cacicedo,3 Aylen Vanessa Ospina,4 Miguel Ángel Ticona,5 Héctor Galindo,6 Marcos David Pereira,7 José Luis Aguilar-Ponce,8 Antonio Rueda-Domínguez,9 Tannia Soria,10 Miren Taberna,11 Lara Iglesias,12 Taysser Sowley,13 Ricard Mesía14 On behalf of TTCC group (Spanish Group for the Treatment of the Head and Neck Cancer)1Instituto Alexander Fleming, Asociación Argentina de Oncología Clínica (AAOC), Buenos Aires, Argentina; 2AC Camargo Cancer Center, Sociedade Brasileira de Oncologia Clínica (SBOC), São Paulo, Brazil; 3Hospital Universitario Cruces/Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain; 4ICCAL, Hospital Universitario Fundación Santa Fe de Bogotá, Asociación Colombiana de Hematología y Oncología (ACHO), Bogotá, Colombia; 5Hospital Nacional Edgardo Rebagliati Martins de Lima, Sociedad Peruana de Oncología Médica (SPOM), Lima, Perú; 6Pontificia Universidad Católica de Chile, Sociedad Chilena de Oncología Médica (SCOM), Santiago, Chile; 7Instituto de Oncología Ángel H. Roffo, Asociación Argentina de Oncología Clínica (AAOC), Buenos Aires, Argentina; 8Instituto Nacional de Cancerología, Sociedad Mexicana de Oncología (SMeO), Mexico City, Mexico; 9UGC Oncología Médica, Hospital Universitario Regional y Virgen de la Victoria, IBIMA, Málaga, Spain; 10Hospital SOLCA de Quito, Sociedad Ecuatoriana de Oncología (SEO), Quito, Ecuador; 11Institut Català d’Oncologia, ICO L’Hospitalet, Barcelona, Spain; 12Hospital 12 de Octubre, Madrid, Spain; 13Instituto Oncológico Nacional (ION) de Panamá, Sociedad Panameña de Oncología (SPO), Panama City, Panama; 14Institut Català d’Oncologia, ICO Badalona, Barcelona, SpainCorrespondence: Ricard MesíaInstitut Català d´Oncologia, ICO Badalona, Barcelona, SpainEmail rmesia@iconcologia.netAbstract: Cisplatin is the standard of treatment for squamous cell carcinoma of the head and neck (SCCHN) that has demonstrated efficacy, either in locally advanced disease when combined with radiotherapy at high doses, or in metastatic/recurrent disease when combined with other agents. However, the usual toxicities related to cisplatin, such as neurotoxicity, nephrotoxicity, ototoxicity, and hematologic toxicities, especially when high doses have been administered, have important implications in the patients’ quality of life. The decision to administer cisplatin depends on several patient factors, such as age, performance status, weight loss, comorbidities, previous toxicities, chronic viral infection, or even the current SARS-CoV-2 pandemic. In order to establish recommendations for the management of patients with SCCHN, a group of experts in medical and radiation oncology from Spain and Latin-American discussed how to identify patients who are not candidates for cisplatin to offer them the most suitable therapeutic alternative.Keywords: age, cisplatin, comorbidities, contraindication, frailty, toxicity