含西妥昔单抗化疗在免疫检查点抑制剂治疗头颈部鳞状细胞癌患者中的安全性和疗效:一项单中心回顾性研究。
Safety and efficacy of cetuximab-containing chemotherapy after immune checkpoint inhibitors for patients with squamous cell carcinoma of the head and neck: a single-center retrospective study.
机构信息
Department of Medical Oncology.
Department of Radiation Oncology.
出版信息
Anticancer Drugs. 2021 Jan 1;32(1):95-101. doi: 10.1097/CAD.0000000000001006.
Immunotherapy has been shown to prolong survival in recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN) in front-line use; however, subsequent systemic therapy has not been optimized. This study aimed to evaluate the safety and efficacy of cetuximab-containing chemotherapy after immunotherapy. We retrospectively analyzed patients with recurrent or metastatic SCCHN who underwent cetuximab-containing regimens after progression on immunotherapy. Of the 22 patients who met the inclusion criteria, 21 received paclitaxel and cetuximab, and 1 carboplatin and fluorouracil and cetuximab after immunotherapy. Nine patients achieved a partial response, 10 patients had stable disease as their best response on cetuximab-containing chemotherapy, yielding an overall response rate and disease control rate of 40.9 and 86.4%, respectively. The median progression-free survival was 5.2 months, and the median overall survival was 14.5 months. Ten patients developed grade 3-4 adverse events, including neutropenia (31.8%), acneiform rash (9.1%), anemia (4.5%), hypertransaminasemia (4.5%) and stomatitis (4.5%). The most frequent cetuximab-related toxicities across all grades were skin reactions (77.3%), hypomagnesemia (40.9%), stomatitis (27.3%), paronychia (13.6%) and keratitis (4.5%). There was no treatment-related death. Taken together, cetuximab-containing chemotherapy was effective and feasible even after immunotherapy.
免疫疗法已被证明可延长一线复发或转移性头颈部鳞状细胞癌(SCCHN)患者的生存期;然而,后续的系统治疗尚未得到优化。本研究旨在评估免疫治疗后含西妥昔单抗化疗的安全性和有效性。我们回顾性分析了免疫治疗进展后接受含西妥昔单抗方案治疗的复发或转移性 SCCHN 患者。符合纳入标准的 22 例患者中,21 例接受紫杉醇联合西妥昔单抗治疗,1 例接受卡铂联合氟尿嘧啶和西妥昔单抗治疗。9 例患者达到部分缓解,10 例患者在含西妥昔单抗化疗中最佳反应为疾病稳定,总缓解率和疾病控制率分别为 40.9%和 86.4%。中位无进展生存期为 5.2 个月,中位总生存期为 14.5 个月。10 例患者发生 3-4 级不良事件,包括中性粒细胞减少症(31.8%)、痤疮样皮疹(9.1%)、贫血(4.5%)、高转氨酶血症(4.5%)和口腔炎(4.5%)。所有级别中最常见的西妥昔单抗相关毒性为皮肤反应(77.3%)、低镁血症(40.9%)、口腔炎(27.3%)、甲周炎(13.6%)和角膜炎(4.5%)。无治疗相关死亡。总之,即使在免疫治疗后,含西妥昔单抗的化疗也是有效且可行的。
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