Simon Alizée, Abdeddaim Cyril, Nguyen DucTrung, Gallet Patrice, Peiffert Didier, Lambert Aurélien, Geoffrois Lionnel
Department of Medical Oncology, Institut de Cancérologie de Lorraine, Nancy, France.
Faculté de médecine de Nancy, Université de Lorraine, Nancy, France.
Head Neck. 2025 Nov;47(11):2939-2949. doi: 10.1002/hed.28211. Epub 2025 Jun 10.
In Europe, pembrolizumab with or without chemotherapy is the recommended first-line treatment for recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC), with a combined positive score (CPS) ≥ 1. In France, the TPExtreme (TPEx) regimen is preferred for CPS < 1. These regimens were studied in selected populations, which may not reflect real-world patients.
We reviewed all R/M HNSCC cases treated with first-line regimens between January 2021 and December 2023 in Nancy and Lille. Data on patient history, treatments, survival, response, and safety were collected. PFS and OS were analyzed using the Cox multivariable regression model, adjusting for the covariates age, Eastern Cooperative Oncology Group (ECOG) performance status, comorbidities, and nutritional status.
The analysis included 290 patients; 19% received pembrolizumab alone, 28% received pembrolizumab with chemotherapy, 19% received TPEx, and 20% received adapted regimens. PFS and OS differed significantly between groups. Median PFS and OS were respectively 2.9 and 9.4 months for pembrolizumab, 6 and 15.5 months for pembrolizumab-chemotherapy, 5.9 and 13.7 months for TPEx, and 4.3 and 10 months for adapted regimens. Pembrolizumab alone is the safest regimen.
This retrospective study reflects real-world first-line therapy for R/M HNSCC in two French cancer institutes. Pembrolizumab combined with chemotherapy is the preferred treatment option.
在欧洲，帕博利珠单抗联合或不联合化疗是推荐用于复发或转移性头颈部鳞状细胞癌（R/M HNSCC）且综合阳性评分（CPS）≥1的一线治疗方案。在法国，对于CPS<1的患者，TPExtreme（TPEx）方案更受青睐。这些方案是在特定人群中进行研究的，可能无法反映真实世界的患者情况。
我们回顾了2021年1月至2023年12月在南希和里尔接受一线方案治疗的所有R/M HNSCC病例。收集了患者病史、治疗、生存、反应和安全性的数据。使用Cox多变量回归模型分析无进展生存期（PFS）和总生存期（OS），并对年龄、东部肿瘤协作组（ECOG）体能状态、合并症和营养状态等协变量进行调整。
分析纳入了290例患者；19%仅接受帕博利珠单抗治疗，28%接受帕博利珠单抗联合化疗，19%接受TPEx方案，20%接受调整后的方案。各组之间的PFS和OS有显著差异。帕博利珠单抗组的中位PFS和OS分别为2.9个月和9.4个月，帕博利珠单抗联合化疗组为6个月和15.5个月，TPEx方案组为5.9个月和13.7个月，调整后的方案组为4.3个月和10个月。仅使用帕博利珠单抗是最安全的方案。
这项回顾性研究反映了法国两家癌症研究所R/M HNSCC的真实世界一线治疗情况。帕博利珠单抗联合化疗是首选的治疗方案。
