scholarly journals Real-world safety and effectiveness of nivolumab for recurrent or metastatic head and neck cancer in Japan: a post-marketing surveillance

Author(s):  
Makoto Tahara ◽  
Naomi Kiyota ◽  
Ken-ichi Nibu ◽  
Ayumi Akamatsu ◽  
Tomohiro Hoshino ◽  
...  

Abstract Background On the basis of phase III CheckMate 141 results, nivolumab was approved for recurrent or metastatic head and neck cancer after undergoing platinum-containing chemotherapy in Japan. This post-marketing surveillance aimed to evaluate the safety and effectiveness of nivolumab for head and neck cancer in the real-world setting. Methods All patients with head and neck cancer who planned to receive nivolumab were centrally registered. This study monitored 607 patients for 6 months to assess nivolumab’s safety, especially treatment-related adverse events (TRAEs) of special interest, and effectiveness. Results TRAEs occurred in 36.1% patients, with no new safety signals. The most common TRAEs with grade ≥ 3 were interstitial lung disease (1.2%), diarrhea (0.8%), and hepatic function abnormal (0.7%). Meanwhile, thyroid dysfunction (10.2%), hepatic dysfunction (5.3%), and interstitial lung disease (4.1%) were the most common TRAE categories of special interest. Although the median time to the onset of each TRAE category of special interest was mostly 1–2 months, most of them occurred throughout the observation period; nonetheless, the majority of patients recovered or remitted. The 6-month survival rate was 55.9%. Conclusion Japanese patients with head and neck cancer treated with nivolumab in the real-world setting manifested no new safety signals. Clinical Trial Registration clinicaltrials.jp: JapicCTI-184071.

2019 ◽  
Vol 30 ◽  
pp. xi24-xi25
Author(s):  
S. Cabezas-Camarero ◽  
D. Gutierrez Abad ◽  
L. Ugidos de la Varga ◽  
J. Corral Jaime ◽  
P. Pérez-Segura

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17563-e17563
Author(s):  
Marcos Antonio Santos ◽  
Luis Felipe Oliveira e Silva ◽  
Hugo Fontan Kohler ◽  
Otavio Curioni ◽  
Ricardo Alencar Vilela ◽  
...  

e17563 Background: the purpose of this study was to compare quality of life (QoL) and overall survival (OS) in patients with locally advanced head and neck cancer treated with radiotherapy only (RT), chemoradiotherapy with cisplatin (CT-RT) or RT with cetuximab (CET-RT). Methods: in this real-world, multi-institutional and prospective study, QoL outcomes were assessed using EORTC QLQ-C30 and QLQ-H&N43 questionnaires. Patients were treated according to each participating institution’s protocol. The Item Response Theory was used to generate a global QoL score, based on the 71 questions of both forms. Questionnaires were completed before treatment and every three months, thereafter. Survival was calculated using the Kaplan-Meyer method, and groups were compared by the log-rank test. The impact of the treatment modalities on QoL was analyzed using multivariate regression analyses. Results: Six hundred and twenty-six patients, with tumors located at the oral cavity (36%), oropharynx (30%), larynx (21%), hypopharynx (9%) and nasopharynx (4%) were included. Median follow up was 10.2 months. RT was delivered to 39% of the patients while 58% received CT-RT and 3% received CET-RT. Patients submitted to surgery were not included. OS was higher when systemic treatment was added to RT (median OS CET-RT: 21.9 months and CT-RT: 24.3 months, versus 14.2 months with RT, p < 0.05). A decrease in QoL during treatment was observed in all patients’ groups, but CT-RT had a statistically significant negative impact on QoL when compared to CET-RT (p = 0.02). An important limitation of the study is the low number of patients that received this last treatment modality, what is, probably, a result of local policies on reimbursement. Other factors that influenced QoL were alcohol consumption (better QoL for patients with no history of chronic alcohol consumption, p = 0.007) and radiotherapy technique (better QoL for patients treated with intensity-modulated RT, when compared to conformal RT, p < 0.001). Conclusions: We observed, as expected, better OS with systemic therapy, when associated to RT. A decrease in QoL was detected, as well, during treatment, but a less pronounced decrease was seen in patients receiving CET-RT, when compared to CT-RT. More studies are needed to confirm the QoL improvement in patients submitted to this last treatment approach.


2020 ◽  
Vol 31 (10) ◽  
pp. 1074-1083
Author(s):  
Silvia Mezi ◽  
Giulia Pomati ◽  
Andrea Botticelli ◽  
Michela Roberto ◽  
Bruna Cerbelli ◽  
...  

2021 ◽  
Author(s):  
Hundo Cho ◽  
Seok Yun Kang ◽  
Hyun Woo Lee ◽  
Yong Won Choi ◽  
Tae-Hwan Kim ◽  
...  

Abstract Background The risk of thromboembolic events (TEE) in cancer patients, especially those receiving cisplatin-based chemotherapy, is higher than that of general population. Methods The study investigated the incidence of TEE in 257 head and neck (H&N) cancer patients, during or within 6 months of completion of concurrent chemoradiotherapy (CCRT) with cisplatin, and analyzed factors affecting TEE occurrence. Results TEE occurred in 5 patients, an incidence rate of 1.9%. Khorana score was the only factor associated with TEE occurrence (p = 0.010). Conclusions The incidence of TEE in H&N cancer patients who underwent CCRT with cisplatin was relatively low when compared to other types of cancer. However, patients with a high Khorana score require more careful surveillance for possible TEE occurrence.


2020 ◽  
Author(s):  
Agustín Falco ◽  
Mariano Leiva ◽  
Albano Blanco ◽  
Guido Cefarelli ◽  
Andrés Rodriguez ◽  
...  

Abstract BACKGROUNDThe association of platinum, taxanes, and cetuximab has proven to be an effective and safe strategy for head and neck cancer treatment. Here we present a multi-institutional real-world experience of the TPEx schema as first-line therapy in advanced squamous cell carcinoma of the head and neck (SCCHN).METHODS This retrospective multicenter cohort study included patients with histologically confirmed recurrent or metastatic SCCHN treated with first-line TPEx regimen at five medical centers in Argentina between January 1, 2017, and April 31, 2020. Chemotherapy consisted of four cycles of docetaxel, cisplatin, and cetuximab, followed by cetuximab maintenance. Clinical outcomes and toxicity profiles were evaluated. RESULTSTwenty-four patients were included. Median age at diagnosis was 58 years (range 36-77). The majority of patients (83.3%) received at least four chemotherapy cycles in the initial part. In the included group, overall response rate was 62.5%, and three patients achieved a complete response (12.5%). The median time to response was 2.4 months (95% CI 1.3-3.5). With a median follow-up of 12.7 months (95% CI 8.8-16.6), the median progression-free survival was 6.9 months (95% CI: 6.5-7.3), and the overall survival rate at 12 months was 82.4%. Two-thirds of patients reported at least one treatment-related adverse event, and 25% presented grade 3-4 toxicities.CONCLUSIONSTPEx was an adequately tolerated regimen in our population. Median progression-free survival and overall response rates were consistent with recent reports in clinical trials evaluating this treatment combination.


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