Department of Medical Oncology, Hôpital Saint-André, CHU Bordeaux-University of Bordeaux, 1 Rue Jean Burguet, Bordeaux, 33000, France.
Department of Medical Oncology, Léon Bérard Center, University of Lyon, Lyon, France.
BMC Cancer. 2023 Jul 14;23(1):663. doi: 10.1186/s12885-023-11133-5.
Patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M-HNSCC) have a poor prognosis and limited therapeutic options. Immune checkpoint inhibitors (ICIs) are effective in patients with tumor progression < 6 months following first-line, platinum-based chemotherapy (PBC), but data are missing for patients with progression ≥ 6 months after the last platinum dose.
Retrospective analysis (six French centers, 2008-2019) of all consecutive R/M-HNSCC patients. treated first-line with PBC and tumor progression ≥ 6 months after the last platinum dose.
progression-free survival after second-line therapy (PFS2). Additional endpoints: overall survival from Day 1 of first-line (OS1) and second-line (OS2) therapy.
R/M-HNSCC patients (n = 144) received cisplatinum (n = 67, 47%) or carboplatinum (n = 77, 53%) first-line. Response after first-line: complete response (CR; n = 16, 11%); partial response (PR; n = 77, 53%); stable disease (n = 22, 15%). Second-line therapy: PBC (n = 95, 66%); platinum-free regimen (PFR) (n = 25, 17%); ICI (n = 24, 17%). Median [95% confidence interval] PFS (months): PBC 5.0 [3.8-6.2]; PFR 4.0 [1-7.0]; ICI 2.0 [0.4-3.6] (p = 0.16). For PBC, PFR, and ICI, respectively: OS1 30, 23, and 29 months (p = 1.02); OS2 14, 10, and 16 months (p = 0.25); PR, 26%, 16%, and 21% patients; CR, 0%, 8%, and 4% patients. For subsequent lines, ICIs were administered for PBC (n = 11, 12%) and PFR (n = 2, 8%). No predictive factor for efficacy (PFS, OS) was identified.
Our retrospective study suggests similar efficacy regarding OS2 for second-line chemotherapy or ICI in R/M-HNSCC patients with progression ≥ 6 months after the last first-line platinum dose.
复发或转移性头颈部鳞状细胞癌（R/M-HNSCC）患者预后较差，治疗选择有限。免疫检查点抑制剂（ICI）在肿瘤进展后<6 个月接受一线铂类化疗（PBC）的患者中有效，但在最后一次铂类剂量后进展≥6 个月的患者中缺乏数据。
回顾性分析（法国六个中心，2008-2019 年）所有接受一线 PBC 治疗且最后一次铂类剂量后进展≥6 个月的 R/M-HNSCC 患者。
二线治疗后的无进展生存期（PFS2）。附加终点：一线（OS1）和二线（OS2）治疗的总生存期。
R/M-HNSCC 患者（n=144）一线接受顺铂（n=67，47%）或卡铂（n=77，53%）。一线治疗后的反应：完全缓解（CR；n=16，11%）；部分缓解（PR；n=77，53%）；稳定疾病（n=22，15%）。二线治疗：PBC（n=95，66%）；无铂方案（PFR；n=25，17%）；ICI（n=24，17%）。中位[95%置信区间]PFS（月）：PBC 5.0[3.8-6.2]；PFR 4.0[1-7.0]；ICI 2.0[0.4-3.6]（p=0.16）。对于 PBC、PFR 和 ICI，分别为：OS1 30、23 和 29 个月（p=1.02）；OS2 14、10 和 16 个月（p=0.25）；PR 患者分别为 26%、16%和 21%；CR 患者分别为 0%、8%和 4%。对于后续的治疗线，ICI 用于 PBC（n=11，12%）和 PFR（n=2，8%）。未确定疗效（PFS、OS）的预测因素。
我们的回顾性研究表明，对于最后一次一线铂类剂量后进展≥6 个月的 R/M-HNSCC 患者，二线化疗或 ICI 治疗的 OS2 疗效相似。
