Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France.
Department of Medical Oncology, Hôpital Saint-André, Bordeaux University Hospital-CHU Bordeaux, France.
Eur J Cancer. 2019 Nov;121:123-129. doi: 10.1016/j.ejca.2019.08.026. Epub 2019 Sep 28.
Immune checkpoint inhibitors (ICI) are active in patients with recurrent/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). Recent data suggest that exposure to ICI improves response to salvage chemotherapy (SCT) in advanced non-small-cell lung cancer. We evaluated response to chemotherapy in patients who had progressed on ICI in patients with R/M SCCHN.
A retrospective study was conducted at 4 French centres. Eligibility criteria were patients who progressed after treatment with ICI for R/M SCCHN and received SCT and for whom efficacy data were available between September 2014 and January 2018.
Of 232 patients treated with ICI, 82 met eligibility criteria: 84% were male. ICI was given as monotherapy in 45% of patients or as combination in 55%. SCT included taxanes (56.1%), cetuximab in combination with taxanes or platinum (50%), platinum-based regimen (36.6%). The median number of treatment lines before SCT was 2 (range 1-6). The objective response rate (ORR) to SCT was 30%. Three patients (4%) presented complete response and 22 patients (27%) had partial response. Median progression-free survival was 3.6 months and median overall survival was 7.8 months. The age at SCT, initial tumour location, number of prior chemotherapy regimens, type of chemotherapy before ICI, best response to ICI, site of relapse and Eastern Cooperative Oncology Group at SCT were not associated with response to SCT on univariate analysis.
In R/M SCCHN, the ORR to SCT was high (30%) suggesting that exposure to ICI may increase tumour sensitivity to chemotherapy.
免疫检查点抑制剂（ICI）在复发性/转移性头颈部鳞状细胞癌（R/M SCCHN）患者中具有活性。最近的数据表明，ICI 暴露可改善晚期非小细胞肺癌患者挽救性化疗（SCT）的反应。我们评估了在 R/M SCCHN 患者中ICI 治疗进展后的患者对化疗的反应。
在 4 个法国中心进行了回顾性研究。入选标准为接受 R/M SCCHN 治疗后进展并接受 SCT 的患者，且在 2014 年 9 月至 2018 年 1 月之间有疗效数据。
在 232 例接受 ICI 治疗的患者中，有 82 例符合入选标准：84%为男性。ICI 单药治疗占 45%，联合治疗占 55%。SCT 包括紫杉烷（56.1%）、西妥昔单抗联合紫杉烷或铂类药物、铂类药物方案（36.6%）。SCT 前的治疗线中位数为 2 条（范围 1-6 条）。SCT 的客观缓解率（ORR）为 30%。3 例（4%）患者完全缓解，22 例（27%）患者部分缓解。中位无进展生存期为 3.6 个月，中位总生存期为 7.8 个月。SCT 时的年龄、初始肿瘤位置、先前化疗方案的数量、ICI 前的化疗类型、ICI 的最佳反应、复发部位和东部肿瘤协作组（ECOG）评分在单因素分析中与 SCT 的反应无关。
在 R/M SCCHN 中，SCT 的 ORR 较高（30%），提示ICI 暴露可能增加肿瘤对化疗的敏感性。
