Salvage chemotherapy after progression on immunotherapy in recurrent/metastatic squamous cell head and neck carcinoma
Llop, Sandra (Institut Català d'Oncologia)
Plana Serrahima, Maria (Institut Català d'Oncologia)
Tous, Sara (Institut d'Investigació Biomèdica de Bellvitge)
Ferrando Díez, Angelica (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Brenes, Jesús (Institut Català d'Oncologia)
Juarez, Marc (Institut Català d'Oncologia)
Vidales, Zara (Institut Català d'Oncologia)
Vilajosana, Essther (Institut Català d'Oncologia)
Linares, Isabel (Institut Català d'Oncologia)
Arribas, Lorena (Institut d'Investigació Biomèdica de Bellvitge)
Duch, Maria (Hospital Universitari de Bellvitge)
Fulla, Marta (Hospital Universitari de Bellvitge)
Brunet, Aina (Hospital Universitari de Bellvitge)
Lozano, Alicia (Institut Català d'Oncologia)
Cirauqui, Beatriz (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Mesia, Ricard (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Oliva, Marc (Institut Català d'Oncologia)

Data:	2024
Resum:	Objectives: Anti-PD-(L)1 agents changed the landscape of recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) treatment. Previous studies showed improved response rates to salvage chemotherapy (SCT) after progression to anti-PD-(L)1 agents. This study aims to evaluate the outcomes of SCT and to identify predictors of response and survival in patients with R/M HNSCC. Materials and methods: Retrospective cohort analysis of 63 R/M patients treated with SCT after antiPD-(L1)-based therapy between January 2015 and August 2022. The overall response rate (ORR) was evaluated. Progression-free survival (PFS) and overall survival (OS) were estimated with Kaplan-Meier method. Progression-free survival 2 was calculated from anti-PD-(L)1-therapy start until progression to SCT (PFS2-I). Logistic regression and Cox regression analyses were performed to identify predictors of outcome. Results: A total of 63 patients were included: 76% were men, and median age was 60 years. PD-L1 status was available in 68% (61% positive). Up to 71% received SCT as third line or beyond. ORR to SCT was 49% with higher rates in PD-L1 positive tumors, 71% vs. 18% (p=0. 001), and cetuximab-containing regimens, 68% vs. 39% (p=0. 026). PD-L1 status was the only predictor of ORR in the adjusted model (OR=8. 6, 95% CI 1. 7-43. 0). OS and PFS were 9. 3 months (95% CI, 6. 5-12. 3) and 4. 1 months (95% CI, 3. 0-5. 8) respectively. PFS2-I was 8. 6 months (95% CI, 6. 6-10. 5). In the multivariate analysis, PD-L1 was the only independent factor for OS (HR=0. 3; 95% CI, 0. 1-0. 7), PFS (HR=0. 2; 95% CI, 0. 1-0. 5; p<0. 001), and PFS2-I (HR=0. 2; 95% CI 0. 1-0. 5; p<0. 001). Conclusion: PDL1 status appeared as a strong predictor of response of efficacy for SCT after anti-PD-(L)1 agents. Patients receiving cetuximab-containing regimens trended towards greater benefit. This highlights the importance of treatment sequencing and personalized treatment strategies.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Head and neck ; Squamous cell carcinoma ; HNSCC ; Immunotherapy ; Anti-PD-(L)1 ; Salvage chemotherapy ; SCT ; Treatment sequencing
Publicat a:	Frontiers in Oncology, Vol. 14 (2024) , art. 1458479, ISSN 2234-943X

DOI: 10.3389/fonc.2024.1458479
PMID: 39655068

9 p, 507.3 KB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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