头颈部鳞状细胞癌中西妥昔单抗和免疫检查点抑制剂的治疗顺序对结局有不同影响。
Treatment sequence of cetuximab and immune checkpoint inhibitor in head and neck squamous cell carcinoma differentially affects outcomes.
机构信息
Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, United States.
Massachusetts Eye and Ear, 243 Charles St, Boston, MA 02114, United States.
出版信息
Oral Oncol. 2020 Dec;111:105024. doi: 10.1016/j.oraloncology.2020.105024. Epub 2020 Oct 13.
OBJECTIVES
To examine the impact of treatment sequences of Immune checkpoint inhibitor (ICI) and cetuximab on clinical outcomes in patients with recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC).
MATERIALS AND METHODS
Clinicopathologic data were retrospectively collected on patients with R/M HNSCC who received ICI treatment. Association between treatment sequence and clinical outcomes were assessed.
RESULTS
A total of 113 patients with R/M HNSCC were analyzed. Patients who had cetuximab prior to ICI had worse overall (HR, 1.83) and progression-free survival (HR, 1.76) compare to those without prior cetuximab. Among patients who had subsequent therapy after ICI, cetuximab-based therapy was associated with a trend toward higher response rate and longer survival than non-cetuximab regimen.
CONCLUSION
Our single institution analysis showed that treatment sequence of cetuximab and ICI in R/M HNSCC may affect clinical outcomes. Cetuximab prior to ICI was associated with worse outcomes while the efficacy of cetuximab may be enhanced after ICI therapy.
目的
研究免疫检查点抑制剂（ICI）和西妥昔单抗治疗顺序对复发性或转移性（R/M）头颈部鳞状细胞癌（HNSCC）患者临床结局的影响。
材料与方法
回顾性收集接受 ICI 治疗的 R/M HNSCC 患者的临床病理数据。评估治疗顺序与临床结局之间的关系。
结果
共分析了 113 例 R/M HNSCC 患者。与未接受西妥昔单抗治疗的患者相比，先接受西妥昔单抗治疗后再接受 ICI 治疗的患者总生存期（HR，1.83）和无进展生存期（HR，1.76）更差。在接受 ICI 治疗后接受后续治疗的患者中，基于西妥昔单抗的治疗方案与更高的缓解率和更长的生存时间相关。
结论
本单中心分析表明，R/M HNSCC 中西妥昔单抗和 ICI 的治疗顺序可能会影响临床结局。ICI 前使用西妥昔单抗与结局较差相关，而 ICI 治疗后西妥昔单抗的疗效可能增强。
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