Age‐based efficacy and safety of nivolumab for recurrent or metastatic head and neck squamous cell carcinoma: A multicenter retrospective study

Background: Cetuximab (CTX) has been approved to be administered concurrently with radiotherapy (RT) to treat locally advanced head and neck squamous cell carcinoma (HNSCC). The aim of this study was to assess the efficacy and safety of concurrent CTX with RT (ExRT). Method: The PubMed, Cochrane Library, EMBASE databases were systematically searched to find relevant articles. The combined hazard ratio (HR), risk ratio (RR) and 95% confidence interval were calculated to assess the efficacy and safety of ExRT in contrast to concurrent platinum-based chemotherapy with RT (ChRT). Results: In total, 32 articles with 4556 patients were included. The pooled HRs indicated that ExRT achieved an unfavorable overall survival (HR: 1.86, p < 0.0001), disease-specific survival (HR: 2.58, p = 0.002), locoregional control (HR: 1.94, p < 0.00001), and progression-free survival (HR: 2.04, p = 0.003) compared with ChRT for locally advanced HNSCC patients. In human papillomavirus-positive patient subgroups, ExRT showed inferior disease-specific survival (HR: 2.55, p = 0.009) and locoregional control (HR: 2.27, p < 0.0001) in contrast to ChRT. Additionally, ExRT increased the occurrence of mucositis (RR: 1.17, p < 0.005), skin toxicity (RR: 6.26, p < 0.00001), and infection (RR: 2.27, p = 0.04) compared with non-CTX groups (ChRT and RT), and was associated with lower incidence of anemia (RR: 0.35, p = 0.009), leukocytopenia (RR: 0.17, p < 0.0001), neutropenia (RR: 0.06, p < 0.0001), nausea/vomiting (RR: 0.23, p < 0.0001), and renal toxicity (RR: 0.14, p = 0.007). Conclusion: ChRT should remain the standard treatment for locally advanced HNSCC patients. ExRT was recognized as an effective alternative treatment for locally advanced HNSCC patients who experienced unbearable toxicities caused by non-CTX treatments.

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Retrospective study of weekly paclitaxel-cetuximab (WPC) in unselected patients (p) with recurrent/metastatic head and neck squamous cell carcinoma (RM-SCCHN)

Annals of Oncology ◽

10.1093/annonc/mdw376.43 ◽

2016 ◽

Vol 27 ◽

pp. vi342

Author(s):

I. Pajares Bernad ◽

J. Mártinez Trufero ◽

L. Calera Urquizu ◽

A. Cebolleo de Miguel ◽

R. Pazo Cid ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Retrospective Study ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Neck Squamous Cell Carcinoma ◽

Weekly Paclitaxel

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A retrospective study on compliance of head and neck squamous cell carcinoma patients to tumor board recommendations

10.1055/s-0038-1640104 ◽

2018 ◽

Author(s):

S Mueller ◽

SY Tan ◽

SY Lee ◽

HK Tan ◽

NG Iyer

Keyword(s):

Squamous Cell Carcinoma ◽

Retrospective Study ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Neck Squamous Cell Carcinoma ◽

Tumor Board

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Efficacy and safety of systemic treatments for patients with recurrent/metastatic head and neck squamous cell carcinoma: A systematic review and network meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18001 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18001-e18001

Author(s):

Lingbin Meng ◽

Rui Ji ◽

Huanhuan Wang ◽

Xin Jiang

Keyword(s):

Systematic Review ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Meta Analysis ◽

Neck Squamous Cell Carcinoma ◽

Efficacy And Safety ◽

Treatment Regimens ◽

Significant Difference

e18001 Background: A variety of systemic chemotherapy regimens have been used for recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). However, most guidelines were derived from a single clinical trial, and no studies have comprehensively compared their efficacy and safety. This study is aimed to compare the efficacy and safety of systemic chemotherapies for patients with R/M HNSCC. Methods: We conducted a systematic review of published studies in PubMed, Embase, Web of Science, and Cochrane Library databases up to July 31, 2020. Studies were included if they were randomized controlled clinical trials including treatment regimens recommended by the latest NCCN guidelines. Eligible studies should report at least one of the following outcomes: overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and ≥3 adverse events rate (AEs). Literature screening, data extraction and quality assessment were independently conducted by two researchers. Disputes were settled by a panel of other researchers. Network meta-analysis was used to compare the efficacy and safety of various treatment regimens. Heterogeneity and consistency using the Bayesian model were evaluated in the network meta-analysis. Results: Eighteen eligible trials involving 4930 patients and 15 treatment regimens were included. Cetuximab/platinum/5-FU regimen showed higher ORR values than the following agents, including cisplatin/5-FU (odds ratio 2.96, 95% credible interval 1.42 to 6.15), cisplatin (5.43, 1.90-15.54), 5-FU (8.12, 2.22-29.61), methotrexate (8.25, 2.86-23.79), cetuximab (10.16, 1.44-71.48), and afatinib (3.64, 1.00-13.32). Immunotherapy regimens pembrolizumab/platinum/5-FU and pembrolizumab alone also showed significantly higher ORR values than these agents, while nivolumab alone showed higher ORR than the single agents. However, no significant difference was observed between Cetuximab/platinum/5-FU and pembrolizumab/platinum/5-FU. Regarding ≥3 AEs, cisplatin/paclitaxel caused the highest toxicity. No significant difference was observed on OS and PFS among all these treatment regimens. Conclusions: Cetuximab/platinum/5-FU, pembrolizumab/platinum/5-FU or pembrolizumab alone displayed high ORR with low AE rate. Nivolumab also showed better efficacy than other single agents. Although it was reported that pembrolizumab/platinum/5-FU showed better efficacy than cetuximab/platinum/5-FU, we did not find a statistically significant improvement in ORR, OS or PFS when comparing the two regimens. Therefore, further prospective trials comparing these treatment regimens remain warranted.

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