Dr. Wirth on the Utility of Tipifarnib in Head and Neck Cancer

Lori J. Wirth, MD, associate professor of medicine, Harvard Medical School, medical director, Center for Head and Neck Cancers, Massachusetts General Hospital, discusses the utility of tipifarnib in patients with head and neck cancer whose tumors harbor HRAS mutations.

The phase 2 KO-TIP-001 trial (NCT02383927) investigated the activity of tipifarnib in HRAS-mutant head and neck cancer. The AIM-HN cohort included 59 patients with high HRAS variant allele frequency (VAF) and 21 patients with low HRAS VAF frequency.

Patients with high VAF frequency of 20% or more achieved more frequent responses with the agent, with an overall response rate of 56%, according to Wirth. The responses were durable, and a long median progression-free survival (PFS) was also observed with tipifarnib, Wirth says. Patients who received the agent experienced a median PFS of 6.1 months vs 2.8 months with their last therapy received.

Furthermore, tipifarnib was generally well tolerated. Adverse effects (AEs) included bone marrow toxicity, fatigue, and other grade 1 or 2 AEs, Wirth adds. Tipifarnib is not currently approved by the FDA for patients with head and neck cancer, Wirth adds. Following the November 2011 FDA approval of the EGFR monoclonal antibody cetuximab (Erbitux) for patients with head and neck cancer, tipifarnib may be next in line for this patient population, Wirth concludes.