Department of Otorhinolaryngology & Head and Neck Surgery, Graduate School of Medicine, Akita University, Akita 010-8543, Japan.
Medicina (Kaunas). 2021 Oct 23;57(11):1151. doi: 10.3390/medicina57111151.
: In recent years, the effectiveness of chemotherapy after immune checkpoint inhibitor administration has attracted attention in various cancers, including head and neck cancers. However, individual assessments of the administered chemotherapy regimens are insufficient. This study aimed to evaluate the efficacy and safety of chemotherapy after immune checkpoint inhibitor administration in recurrent metastatic head and neck cancer by focusing on a single regimen. : We retrospectively reviewed clinical and radiological data from the medical records of 18 patients with recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) who received systemic chemotherapy with weekly cetuximab and paclitaxel (Cmab + PTX) after progression following immune checkpoint inhibitor (ICI) therapy. The objective response rate (ORR) and disease control rate (DCR) were assessed using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Adverse events (AEs) were recorded using National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. : In all patients, the ORR, DCR, median PFS, and median OS were 44.4%, 72.2%, 3.8 months, and 9.6 months, respectively. Regarding AEs, three patients developed grade 3 neutropenia. Grade 3 anemia, paronychia, asthenia, and peripheral neuropathy were observed in one patient each. There were no treatment-related deaths. : Cmab + PTX was shown to maintain high efficacy and acceptable safety for R/M HNSCC that progressed after ICI therapy. Further research is needed to establish optimal treatment sequences and drug combinations for recurrent R/M HNSCC.
近年来，免疫检查点抑制剂治疗后化疗的有效性在包括头颈部癌症在内的各种癌症中引起了关注。然而，对所给予的化疗方案进行个体评估是不够的。本研究旨在通过关注单一方案，评估免疫检查点抑制剂治疗后复发转移性头颈部癌患者接受化疗的疗效和安全性。
我们回顾性分析了 18 例复发或转移性（R/M）头颈部鳞状细胞癌（HNSCC）患者的临床和影像学资料，这些患者在免疫检查点抑制剂（ICI）治疗后进展时接受了每周西妥昔单抗联合紫杉醇（Cmab + PTX）的全身化疗。使用实体瘤反应评估标准（RECIST）1.1 评估客观缓解率（ORR）和疾病控制率（DCR）。使用 Kaplan-Meier 法估计无进展生存期（PFS）和总生存期（OS）。使用国家癌症研究所不良事件通用术语标准 4.0 记录不良事件（AE）。
在所有患者中，ORR、DCR、中位 PFS 和中位 OS 分别为 44.4%、72.2%、3.8 个月和 9.6 个月。关于 AE，有 3 例患者发生 3 级中性粒细胞减少症。1 例患者出现 3 级贫血、甲沟炎、乏力和周围神经病。无治疗相关死亡。
Cmab + PTX 显示在 ICI 治疗后进展的 R/M HNSCC 中具有较高的疗效和可接受的安全性。需要进一步研究以确定复发性 R/M HNSCC 的最佳治疗顺序和药物组合。
