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一线西妥昔单抗联合铂类为基础的治疗复发性/转移性头颈部鳞状细胞癌的真实世界观察性研究-ENCORE。

First-line cetuximab + platinum-based therapy for recurrent/metastatic head and neck squamous cell carcinoma: A real-world observational study-ENCORE.

机构信息

Department of Drug Development and Innovation (D3i), Institut Curie, Paris, France.

INSERM U900 Research Unit, Saint-Cloud, France.

出版信息

Cancer Rep (Hoboken). 2023 May;6(5):e1804. doi: 10.1002/cnr2.1804. Epub 2023 Apr 17.

Abstract

BACKGROUND

ENCORE, an observational, prospective, open-label study, investigated real-world treatment practices and outcomes with cetuximab plus platinum-based therapy (PBT) in first-line (1L) recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN).

AIMS

This multinational study aimed to investigate the long-term use of cetuximab plus PBT for 1L R/M SCCHN in a clinical setting. In particular, this study aimed to explore clinical considerations such as the decision to prescribe cetuximab plus PBT in R/M SCCHN, the mode and duration of treatment, and patient outcomes.

METHODS AND RESULTS

Previously untreated patients with R/M SCCHN whose planned treatment was cetuximab plus PBT were enrolled from 6 countries. Among 221 evaluable patients, planned treatments included cetuximab plus carboplatin (31.2%), cisplatin plus 5-fluorouracil (31.7%), or carboplatin plus 5-fluorouracil (23.1%); 3.2% included a taxane, and 45.2% did not include 5-fluorouracil. Cetuximab treatment was planned for a fixed duration (≤24 weeks) in 15 patients (6.8%) and until disease progression in 206 (93.2%). Median progression-free survival and overall survival were 6.5 and 10.8 months, respectively. Grade ≥3 adverse events occurred in 39.8% of patients. Serious adverse events occurred in 25.8% of patients; 5.4% were cetuximab-related.

CONCLUSION

In patients with R/M SCCHN, first-line cetuximab plus PBT was feasible and modifiable in a real-world setting with similar toxicity and efficacy as in the pivotal phase III EXTREME trial.

CLINICAL TRIAL REGISTRATION NUMBER

EMR 062202-566.

摘要

背景

ENCORE 是一项观察性、前瞻性、开放性研究,调查了西妥昔单抗联合铂类为基础的治疗(PBT)在一线(1L)复发性和/或转移性头颈部鳞状细胞癌(R/M SCCHN)中的真实世界治疗实践和结果。

目的

本多中心研究旨在调查在临床环境中西妥昔单抗联合 PBT 用于 1L R/M SCCHN 的长期使用情况。特别是,本研究旨在探讨临床考虑因素,如在 R/M SCCHN 中开具西妥昔单抗联合 PBT 的决定、治疗方式和持续时间以及患者结局。

方法和结果

从 6 个国家招募了未接受过治疗的 R/M SCCHN 患者,其计划治疗为西妥昔单抗联合 PBT。在 221 例可评估患者中,计划治疗包括西妥昔单抗联合卡铂(31.2%)、顺铂联合 5-氟尿嘧啶(31.7%)或卡铂联合 5-氟尿嘧啶(23.1%);3.2%包括紫杉烷,45.2%不包括 5-氟尿嘧啶。15 例(6.8%)患者西妥昔单抗治疗计划为固定疗程(≤24 周),206 例(93.2%)患者直至疾病进展。无进展生存期和总生存期中位数分别为 6.5 个月和 10.8 个月。39.8%的患者发生≥3 级不良事件。25.8%的患者发生严重不良事件;5.4%与西妥昔单抗相关。

结论

在 R/M SCCHN 患者中,一线西妥昔单抗联合 PBT 在真实世界环境中是可行的,且可调整,其毒性和疗效与关键性 III 期 EXTREME 试验相似。

临床试验注册号

EMR 062202-566。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff5b/10172179/f87cd207dd90/CNR2-6-e1804-g001.jpg

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