Retrospective Study of Cisplatin/Carboplatin, 5-Fluorouracil Plus Cetuximab (EXTREME) for Advanced-stage Salivary Gland Cancer

In Vivo. 2022 Mar-Apr;36(2):979-984. doi: 10.21873/invivo.12790.


Background/aim: Surgery remains the standard treatment for salivary gland carcinoma (SGC). Our study investigated the association between epidermal growth factor receptor (EGFR) status in recurrent/metastatic SGC and the effectiveness of treatment with cisplatin/carboplatin and 5-fluorouracil plus cetuximab (EXTREME).

Patients and methods: We retrospectively collected 19 SGCs from patients treated with the EXTREME regimen. After analyzing EGFR expression and gene copy number gain, we evaluated the correlation between EGFR status and clinicopathological factors and prognosis.

Results: EGFR overexpression was detected in 77.8% cases, but not statistically associated with clinicopathological factors or prognosis. EGFR gene copy number gain was detected in 16.7% cases, and statistically positively correlated with lymph node metastasis (p=0.0291). The best overall response was partial response in two cases, stable disease in 15, and progressive disease in one case. The EXTREME regimen was discontinued in all cases.

Conclusion: Our results suggest that SGCs are positive for EGFR protein expression but the response rate to the EXTREME regimen was unremarkable.

Keywords: EGFR; Salivary gland caner; cetuximab; fluorescent in situ hybridization; immunohistochemical stain; near-infrared photoimmunotherapy.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Carboplatin / adverse effects
  • Cetuximab / adverse effects
  • Cisplatin* / therapeutic use
  • Fluorouracil
  • Humans
  • Neoplasm Recurrence, Local / pathology
  • Retrospective Studies
  • Salivary Gland Neoplasms*


  • Carboplatin
  • Cetuximab
  • Cisplatin
  • Fluorouracil