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Matoba T, Minohara K, Kawakita D, Sawabe M, Takano G, Oguri K, Murashima A, Iwaki S, Tsuge H, Imaizumi S, Hojo W, Kondo A, Tsukamoto K, Iwasaki S. Impact of salvage chemotherapy after immune checkpoint inhibitor for recurrent or metastatic head and neck cancer. Head Neck 2024; 46:1855-1864. [PMID: 38229255 DOI: 10.1002/hed.27643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/16/2023] [Accepted: 01/08/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND It is unclear witch regimen is optimal as salvage chemotherapy (SCT) after immune checkpoint inhibitor (ICI) monotherapy for recurrent or metastatic head and neck cancer (RM-HNC). METHODS This study enrolled 109 patients. Overall survival (OS) and progression-free survival 2 (PFS2) were compared between patients stratified by SCT regimen. RESULTS Of the 109 patients, 55 underwent SCT after the failure of ICI monotherapy. The OS of these 55 patients was longer than that of patients who did not undergo SCT. The OS and PFS2 were similar between patients treated with paclitaxel (PTX) and cetuximab (Cmab) combination and those treated with PTX monotherapy. The occurrence of irAEs did not impact PFS2 nor OS. CONCLUSIONS SCT can improve the survival outcomes of patients with RM-HNC. In addition to PTX and Cmab, PTX monotherapy is also considered an effective SCT regimen. SCT is effective regardless of the presence or absence of irAEs.
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Affiliation(s)
- Takuma Matoba
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kiyoshi Minohara
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Daisuke Kawakita
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Michi Sawabe
- Department of Otorhinolaryngology, Toyota Kosei Hospital, Toyota, Japan
| | - Gaku Takano
- Department of Otorhinolaryngology, Nagoya City University West Medical Center, Nagoya, Japan
| | - Keisuke Oguri
- Department of Otorhinolaryngology, Anjo Kosei Hospital, Anjo, Japan
| | - Akihiro Murashima
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Sho Iwaki
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiroshi Tsuge
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Sae Imaizumi
- Department of Head and Neck Surgery, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Wataru Hojo
- Department of Otorhinolaryngology, Anjo Kosei Hospital, Anjo, Japan
| | - Ayano Kondo
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Koji Tsukamoto
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Shinichi Iwasaki
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Otsuru M, Yamakawa N, Kirita T, Yamada SI, Kurita H, Kugimoto T, Harada H, Hasegawa T, Akashi M, Takeshita A, Uzawa N, Umeda M, Yanamoto S, Yamada T. Efficacy and safety of molecularly targeted agents and immune checkpoint inhibitors for unresectable or recurrent/metastatic oral cancer in Japan. J Dent Sci 2024; 19:1628-1637. [PMID: 39035308 PMCID: PMC11259634 DOI: 10.1016/j.jds.2023.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 11/28/2023] [Indexed: 07/23/2024] Open
Abstract
Background/purpose For unresectable recurrent/metastatic head and neck cancer, pembrolizumab alone or pembrolizumab combined with cisplatin and 5-fluorouracil is the first-line therapy, depending on the PD-L1 combined positive score (CPS). However, this is based on clinical studies of head and neck cancer, and few similar studies have been conducted on oral cancer alone. This study aimed to investigate the current status of pharmacotherapy for unresectable, recurrent, or metastatic oral cancer. Materials and methods Patients with unresectable or recurrent/metastatic oral cancer who received cetuximab, nivolumab, or pembrolizumab as first-line treatment were reviewed. Overall survival (OS), progression-free survival (PFS), PFS 2 (PFS2), overall response rate (ORR), disease control rate (DCR), and immune-related adverse events were obtained from medical records. Results A total of 155 patients were enrolled from six hospitals. The ORR in the nivolumab, pembrolizumab, and cetuximab groups was 17.2 %, 4.2 %, and 21.6 %, respectively, and the DCR was 37.9 %, 41.7 %, and 58.8 %, respectively. Median OS in nivolumab, pembrolizumab, and cetuximab groups was 10.3, 9.5, and 11.1 months, respectively. No significant differences were observed in survival among the three groups. The small number of cases and the retrospective nature of the study precluded the determination of the more effective first-line treatment among the three drugs. Conclusion The current statuses of nivolumab, pembrolizumab, and cetuximab in unresectable recurrent metastatic oral cancer was reported.
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Affiliation(s)
- Mitsunobu Otsuru
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Nobuhiro Yamakawa
- Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, Kashihara, Japan
| | - Tadaaki Kirita
- Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, Kashihara, Japan
| | - Shin-ichi Yamada
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Hiroshi Kurita
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takuma Kugimoto
- Department of Oral and Maxillofacial Surgical Oncology, Division of Oral Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroyuki Harada
- Department of Oral and Maxillofacial Surgical Oncology, Division of Oral Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takumi Hasegawa
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masaya Akashi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akinori Takeshita
- Department of Oral and Maxillofacial Surgery 2, Osaka University, School & Graduate School of Dentistry, Osaka, Japan
| | - Narikazu Uzawa
- Department of Oral and Maxillofacial Surgery 2, Osaka University, School & Graduate School of Dentistry, Osaka, Japan
| | - Masahiro Umeda
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Souichi Yanamoto
- Department of Oral Oncology, Hiroshima University, Hiroshima, Japan
| | - Tomohiro Yamada
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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3
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Koyama T, Kiyota N, Boku S, Imamura Y, Shibata N, Satake H, Tanaka K, Hayashi H, Onoe T, Asada Y, Yamazaki T, Nose T, Ohata S, Nagatani Y, Kimbara S, Funakoshi Y, Teshima M, Shinomiya H, Minami H. A phase II trial of paclitaxel plus biweekly cetuximab for patients with recurrent or metastatic head and neck cancer previously treated with both platinum-based chemotherapy and anti-PD-1 antibody. ESMO Open 2024; 9:103476. [PMID: 38833968 PMCID: PMC11179070 DOI: 10.1016/j.esmoop.2024.103476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/24/2024] [Accepted: 04/24/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND An important unmet need for new treatment options remains for patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M-HNSCC) previously treated with both platinum-based chemotherapy and anti-programmed cell death protein 1 (PD-1) antibody. Retrospective studies suggest that previous treatment with immune checkpoint inhibitor might augment the efficacy of subsequent chemotherapy. Here, we conducted a phase II trial aimed to evaluate the efficacy and safety of paclitaxel plus biweekly cetuximab for patients in this setting. PATIENTS AND METHODS This was a single-arm, multicenter, phase II trial. Key eligibility criteria were R/M-HNSCC, and previous treatment with both platinum-based chemotherapy and PD-1 antibody. Paclitaxel plus biweekly cetuximab consisted of weekly paclitaxel 100 mg/m2 (days 1, 8, 15) and biweekly cetuximab 500 mg/m2 (days 1, 15) with a cycle of 28 days until progression or unacceptable toxicity. Primary endpoint was objective response rate (ORR). Secondary endpoints included progression-free survival (PFS), overall survival (OS), disease control rate (DCR), and adverse events (AEs) (Common Terminology Criteria for Adverse Events version 5.0). RESULTS Between August 2020 and August 2022, 35 patients were enrolled, of whom 33 were assessable for response. ORR was 69.6% (95% confidence interval 51.2% to 84.4%). With a median follow-up period for survivors of 16.6 months, median PFS and OS were 5.5 and 13.3 months, respectively. DCR was 93.7%. Twenty-three patients (65%) experienced grade 3 or 4 AEs, including neutropenia (34%), infection (14%), leukopenia (11%), mucositis (8%), and pneumonitis (8%). Eight patients discontinued study treatment due to treatment-related AEs, and no treatment-related death was observed. CONCLUSIONS Paclitaxel plus biweekly cetuximab showed highly encouraging efficacy and manageable toxicities in R/M-HNSCC patients previously treated with both platinum-based chemotherapy and PD-1 antibody. This combination therapy warrants further investigation in this setting.
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Affiliation(s)
- T Koyama
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe. https://twitter.com/hnoncoid
| | - N Kiyota
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe; Cancer Center, Kobe University Hospital, Kobe.
| | - S Boku
- Cancer Treatment Center, Kansai Medical University Hospital, Hirakata. https://twitter.com/ShogenBoku
| | - Y Imamura
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe
| | - N Shibata
- Cancer Treatment Center, Kansai Medical University Hospital, Hirakata. https://twitter.com/shibanob
| | - H Satake
- Cancer Treatment Center, Kansai Medical University Hospital, Hirakata. https://twitter.com/HironagaSATAKE
| | - K Tanaka
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama
| | - H Hayashi
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama
| | - T Onoe
- Department of Medical Oncology, Hyogo Cancer Center, Akashi
| | - Y Asada
- Department of Head and Neck Surgery, Miyagi Cancer Center, Natori
| | - T Yamazaki
- Department of Head and Neck Oncology, Miyagi Cancer Center, Natori
| | - T Nose
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe
| | - S Ohata
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe
| | - Y Nagatani
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe
| | - S Kimbara
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe
| | - Y Funakoshi
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe
| | - M Teshima
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - H Shinomiya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - H Minami
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe; Cancer Center, Kobe University Hospital, Kobe
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4
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Yamakawa N, Umeda M, Yoshii Y, Mitsudo K, Noguchi M, Kusukawa J, Katakura A, Nakayama H, Sasaki M, Noguchi T, Ueda M, Bukawa H, Yagihara K, Horie A, Miyazaki A, Chikazu D, Tomihara K, Mishima K, Otsuru M, Asoda S, Fujiwara S, Ohyama Y, Kurita H, Kawamata H, Fukuda M, Shintani Y, Kobayashi T, Kanno T, Oh-Iwa I, Kawano K, Yamashita Y, Kobayashi W, Ohiro Y, Uzawa K, Ota Y, Kirita T. Multicenter retrospective study of nivolumab for recurrent/metastatic oral squamous cell carcinoma. Oral Dis 2024; 30:247-258. [PMID: 36519515 DOI: 10.1111/odi.14471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/03/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Immunotherapy with nivolumab for patients with recurrent/metastatic oral squamous cell carcinoma has not been evaluated. Here, we aimed to examine the efficacy, safety, and prognostic factors of nivolumab in these patients. MATERIALS AND METHODS This multicenter retrospective observational study involved patients who received nivolumab between April 2017 and June 2019. The patient characteristics were evaluated for association with progression-free and overall survival. Progression-free and overall survival rates were calculated; parameters that were significant in the univariate analysis were used as explanatory variables. Independent factors for progression-free and overall survival were identified using multivariate analysis. RESULTS Totally, 143 patients were included. The overall response and disease control rates were 27.3% and 46.2%, respectively. The median, 1- and 2-year progression-free survival rates were 2.7 months, 25.4%, and 19.2%, respectively; those for overall survival were 11.2 months, 47.3%, and 33.6%, respectively. The independent factors affecting progression-free survival were performance status and immune-related adverse event occurrence, whereas those affecting overall survival were performance status, target disease, and number of previous lines of systemic cancer therapy. Eight patients reported grade ≥3 immune-related adverse events. CONCLUSION Nivolumab was effective for recurrent/metastatic oral squamous cell carcinoma treatment and was well tolerated by patients.
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Affiliation(s)
- Nobuhiro Yamakawa
- Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, Kashihara, Japan
| | - Masahiro Umeda
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yumi Yoshii
- Department of Cancer Genomics and Medical Oncology, Nara Medical University, Kashihara, Japan
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Makoto Noguchi
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Jingo Kusukawa
- Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Japan
| | - Akira Katakura
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - Hideki Nakayama
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Masashi Sasaki
- Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Tadahide Noguchi
- Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, Shimotsuke, Japan
| | - Michihiro Ueda
- Department of Oral Oncology, Hokkaido Cancer Center, Sapporo, Japan
| | - Hiroki Bukawa
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kazuhiro Yagihara
- Department of Oral Surgery, Saitama Cancer Center, Kitaadachi-gun, Japan
| | - Akihisa Horie
- Department of Oral and Maxillofacial Surgery, Kanto Rosai Hospital, Kawasaki, Japan
| | - Akihiro Miyazaki
- Department of Oral Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Daichi Chikazu
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kei Tomihara
- Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Katsuaki Mishima
- Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Mitsunobu Otsuru
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Seiji Asoda
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shigeyoshi Fujiwara
- Department of Oral and Maxillofacial Surgery, Japanese Red Cross Society Himeji Hospital, Himeji, Japan
| | - Yoshio Ohyama
- Department of Oral and Maxillofacial Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - Hiroshi Kurita
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hitoshi Kawamata
- Department of Oral and Maxillofacial Surgery, Dokkyo Medical University School of Medicine, Shimotsuga-gun, Japan
| | - Masayuki Fukuda
- Department of Dentistry and Oral Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Yukari Shintani
- Department of Oral and Maxillofacial Surgery, Wakayama Medical University, Wakayama, Japan
| | - Takanori Kobayashi
- Department of Dentistry and Oral Surgery, Nagaoka Red Cross Hospital, Nagaoka, Japan
| | - Takahiro Kanno
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Japan
| | - Ichiro Oh-Iwa
- Department of Oral and Maxillofacial Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan
| | - Kenji Kawano
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Oita University, Yufu, Japan
| | - Yoshio Yamashita
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Wataru Kobayashi
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yoichi Ohiro
- Oral and Maxillofacial Surgery, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Katsuhiro Uzawa
- Department of Oral Science, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yoshihide Ota
- Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Tadaaki Kirita
- Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, Kashihara, Japan
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Pannunzio S, Di Bello A, Occhipinti D, Scala A, Messina G, Valente G, Quirino M, Di Salvatore M, Tortora G, Cassano A. Multimodality treatment in recurrent/metastatic squamous cell carcinoma of head and neck: current therapy, challenges, and future perspectives. Front Oncol 2024; 13:1288695. [PMID: 38239635 PMCID: PMC10794486 DOI: 10.3389/fonc.2023.1288695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/05/2023] [Indexed: 01/22/2024] Open
Abstract
Squamous cell carcinoma of the head and neck is a complex group of diseases that presents a challenge to the clinician. The prognosis in the recurrent/metastatic disease is particularly dismal, with a median survival of approximately 12 months. Recently, the personalized and multimodal approach has increased prognosis by integrating locoregional strategies (salvage surgery and stereotactic radiotherapy) and systemic treatments (chemotherapy, immunotherapy, and target therapy). Malnutrition is a significant clinical problem that interferes with dose intensity, and thus, feeding supplementation is critical not only to increase the quality of life but also to improve overall survival. With this review, we want to emphasize the importance of the multidisciplinary approach, quality of life, and nutritional supportive care and to integrate the latest updates of predictive biomarkers for immunotherapy and future therapeutic strategies.
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Affiliation(s)
- Sergio Pannunzio
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Armando Di Bello
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Denis Occhipinti
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Alessandro Scala
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Gloria Messina
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Giustina Valente
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Michela Quirino
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Mariantonietta Di Salvatore
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Giampaolo Tortora
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
- Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Alessandra Cassano
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
- Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
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6
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Zheng YM, Che JY, Yuan MG, Wu ZJ, Pang J, Zhou RZ, Li XL, Dong C. A CT-Based Deep Learning Radiomics Nomogram to Predict Histological Grades of Head and Neck Squamous Cell Carcinoma. Acad Radiol 2023; 30:1591-1599. [PMID: 36460582 DOI: 10.1016/j.acra.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/01/2022] [Accepted: 11/10/2022] [Indexed: 12/03/2022]
Abstract
RATIONALE AND OBJECTIVES Accurate pretreatment assessment of histological differentiation grade of head and neck squamous cell carcinoma (HNSCC) is crucial for prognosis evaluation. This study aimed to construct and validate a contrast-enhanced computed tomography (CECT)-based deep learning radiomics nomogram (DLRN) to predict histological differentiation grades of HNSCC. MATERIALS AND METHODS A total of 204 patients with HNSCC who underwent CECT scans were enrolled in this study. The participants recruited from two hospitals were split into a training set (n=124, 74 well/moderately differentiated and 50 poorly differentiated) of patients from one hospital and an external test set of patients from the other hospital (n=80, 49 well/moderately differentiated and 31 poorly differentiated). CECT-based manually-extracted radiomics (MER) features and deep learning (DL) features were extracted and selected. The selected MER features and DL features were then combined to construct a DLRN via multivariate logistic regression. The predictive performance of the DLRN was assessed using ROCs and decision curve analysis (DCA). RESULTS Three MER features and seven DL features were finally selected. The DLRN incorporating the selected MER and DL features showed good predictive value for the histological differentiation grades of HNSCC (well/moderately differentiated vs. poorly differentiated) in both the training (AUC, 0.878) and test (AUC, 0.822) sets. DCA demonstrated that the DLRN was clinically useful for predicting histological differentiation grades of HNSCC. CONCLUSION A CECT-based DLRN was constructed to predict histological differentiation grades of HNSCC. The DLRN showed good predictive efficacy and might be useful for prognostic evaluation of patients with HNSCC.
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Affiliation(s)
- Ying-Mei Zheng
- Health Management Center, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jun-Yi Che
- Department of Radiology, Qingdao Municipal Hospital, Qingdao, China
| | - Ming-Gang Yuan
- Department of Nuclear Medicine, Affiliated Qingdao Central Hospital, Qingdao University, Qingdao, China
| | - Zeng-Jie Wu
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jing Pang
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Rui-Zhi Zhou
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiao-Li Li
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Cheng Dong
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China.
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7
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Harrington KJ, Burtness B, Greil R, Soulières D, Tahara M, de Castro G, Psyrri A, Brana I, Basté N, Neupane P, Bratland Å, Fuereder T, Hughes BG, Mesia R, Ngamphaiboon N, Rordorf T, Wan Ishak WZ, Lin J, Gumuscu B, Swaby RF, Rischin D. Pembrolizumab With or Without Chemotherapy in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: Updated Results of the Phase III KEYNOTE-048 Study. J Clin Oncol 2023; 41:790-802. [PMID: 36219809 PMCID: PMC9902012 DOI: 10.1200/jco.21.02508] [Citation(s) in RCA: 118] [Impact Index Per Article: 118.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 05/09/2022] [Accepted: 07/06/2022] [Indexed: 02/01/2023] Open
Abstract
PURPOSE Pembrolizumab and pembrolizumab-chemotherapy demonstrated efficacy in recurrent/metastatic head and neck squamous cell carcinoma in KEYNOTE-048. Post hoc analysis of long-term efficacy and progression-free survival on next-line therapy (PFS2) is presented. METHODS Patients were randomly assigned (1:1:1) to pembrolizumab, pembrolizumab-chemotherapy, or cetuximab-chemotherapy. Efficacy was evaluated in programmed death ligand 1 (PD-L1) combined positive score (CPS) ≥ 20, CPS ≥ 1, and total populations, with no multiplicity or alpha adjustment. RESULTS The median study follow-up was 45.0 months (interquartile range, 41.0-49.2; n = 882). At data cutoff (February 18, 2020), overall survival improved with pembrolizumab in the PD-L1 CPS ≥ 20 (hazard ratio [HR], 0.61; 95% CI, 0.46 to 0.81) and CPS ≥ 1 populations (HR, 0.74; 95% CI, 0.61 to 0.89) and was noninferior in the total population (HR, 0.81; 95% CI, 0.68 to 0.97). Overall survival improved with pembrolizumab-chemotherapy in the PD-L1 CPS ≥ 20 (HR, 0.62; 95% CI, 0.46 to 0.84), CPS ≥ 1 (HR, 0.64; 95% CI, 0.53 to 0.78), and total (HR, 0.71; 95% CI, 0.59 to 0.85) populations. The objective response rate on second-course pembrolizumab was 27.3% (3 of 11). PFS2 improved with pembrolizumab in the PD-L1 CPS ≥ 20 (HR, 0.64; 95% CI, 0.48 to 0.84) and CPS ≥ 1 (HR, 0.79; 95% CI, 0.66 to 0.95) populations and with pembrolizumab-chemotherapy in the PD-L1 CPS ≥ 20 (HR, 0.64; 95% CI, 0.48 to 0.86), CPS ≥ 1 (HR, 0.66; 95% CI, 0.55 to 0.81), and total (HR, 0.73; 95% CI, 0.61 to 0.88) populations. PFS2 was similar after pembrolizumab and longer after pembrolizumab-chemotherapy on next-line taxanes and shorter after pembrolizumab and similar after pembrolizumab-chemotherapy on next-line nontaxanes. CONCLUSION With a 4-year follow-up, first-line pembrolizumab and pembrolizumab-chemotherapy continued to demonstrate survival benefit versus cetuximab-chemotherapy in recurrent/metastatic head and neck squamous cell carcinoma. Patients responded well to subsequent treatment after pembrolizumab-based therapy.
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Affiliation(s)
- Kevin J. Harrington
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, National Institute of Health Research Biomedical Research Centre, London, United Kingdom
| | | | - Richard Greil
- Salzburg Cancer Research Institute-Center for Clinical Cancer and Immunology Trials, Salzburg, Austria
- Paracelsus Medical University Hospital, and Cancer Cluster Salzburg, Salzburg, Austria
| | - Denis Soulières
- Centre Hospitalier de l’Université de Montréal, Montréal, QC, Canada
| | - Makoto Tahara
- National Cancer Center Hospital East, Kashiwa, Japan
| | | | - Amanda Psyrri
- National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Irene Brana
- Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | - Neus Basté
- Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | | | | | | | - Brett G.M. Hughes
- Royal Brisbane and Women's Hospital and University of Queensland, Brisbane, QLD, Australia
| | - Ricard Mesia
- Medical Oncology Department, Catalan Institut of Oncology - Badalona, B-ARGO Group, IGTP, Badalona, Spain
| | | | | | | | | | | | | | - Danny Rischin
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- University of Melbourne, Parkville, Melbourne, VIC, Australia
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8
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Mosca M, Filippini DM, Tober N, Rojas FL, Rihawi K, Di Fabio F. Unexpected response to fourth-line paclitaxel in a patient with metastatic oropharyngeal squamous cell carcinoma, immunotherapy-refractory: a case report. Anticancer Drugs 2022; 33:691-695. [PMID: 35324531 DOI: 10.1097/cad.0000000000001302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In recent years, immune checkpoint inhibitors (ICIs), including nivolumab and pembrolizumab have revolutionized the treatment landscape in recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC). However, many patients do not respond to ICIs for reasons that remain largely unknown. For patients who progress on ICIs, chemotherapy and/or biologic therapies are the most widely used treatments based on the clinician's choice, with no defined sequence strategy. We report the experience of a patient with metastatic oropharyngeal squamous cell cancer p16 and human papillomavirus-DNA positive who received chemotherapy with weekly paclitaxel after progressing on nivolumab. Our patient presented a partial response to fourth line paclitaxel, which lasted more than 2 years, with an improvement of his quality of life too. These results support the hypothesis of synergism between immunotherapy and conventional chemotherapies. Even in the setting of immune-refractory disease, immunotherapy may affect tumor immune microenvironment thus leading to a synergistic effect with conventional chemotherapy and achieving unexpected results.
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Affiliation(s)
- Mirta Mosca
- Department of Experimental, Diagnostic and Specialty Medicine, Policlinico di Sant'Orsola University Hospital
| | - Daria Maria Filippini
- Department of Experimental, Diagnostic and Specialty Medicine, Policlinico di Sant'Orsola University Hospital
- Division of Medical Oncology, Department of Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Nastassja Tober
- Department of Experimental, Diagnostic and Specialty Medicine, Policlinico di Sant'Orsola University Hospital
| | - Fabiola Lorena Rojas
- Department of Experimental, Diagnostic and Specialty Medicine, Policlinico di Sant'Orsola University Hospital
- Division of Medical Oncology, Department of Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Karim Rihawi
- Department of Experimental, Diagnostic and Specialty Medicine, Policlinico di Sant'Orsola University Hospital
- Division of Medical Oncology, Department of Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Francesca Di Fabio
- Department of Experimental, Diagnostic and Specialty Medicine, Policlinico di Sant'Orsola University Hospital
- Division of Medical Oncology, Department of Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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9
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Gaughan EM, Horton BJ. Outcomes From Cytotoxic Chemotherapy Following Progression on Immunotherapy in Metastatic Melanoma: An Institutional Case-Series. Front Oncol 2022; 12:855782. [PMID: 35574303 PMCID: PMC9096114 DOI: 10.3389/fonc.2022.855782] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/28/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction The role of chemotherapy in the management of advanced melanoma is limited due to low response rates and short survival. Improved outcomes to chemotherapy administered after immunotherapy for metastatic melanoma and other solid tumors have been reported. We studied the outcomes of subjects treated at the University of Virginia (UVA) with chemotherapy following progression on prior systemic immunotherapy and compared the results with the existing literature. Materials and Methods Subjects were identified through an institutional database of patients treated with immunotherapy at UVA. Demographic, pathologic and clinical factors were collected, along with dates of therapy, investigator-assessed best response as per Response Evaluation Criteria for Solid Tumors version 1.1 and dates of death or last follow up. Kaplan-Meier survival estimates and log-rank tests were used to perform time to event analysis of progression free survival and overall survival. Results Forty-five patients were identified who met the inclusion criteria including 24 men and 21 women with a median age of 61 years. All patients had received at least one line of immunotherapy including 64.4% with prior anti-PD1 treatment. The cytotoxic chemotherapy regimens used included carboplatin with paclitaxel (55.6%), temozolomide (31.1%) and nab-paclitaxel (13.3%). The overall response rate for cytotoxic chemotherapy 22.2% and the disease control rate was 35.6%. The median progression-free survival was 1.7 months and median overall survival was 4.7 months. Nineteen (42.2%) patients survived greater than 6 months and seven (15.5%) patients survived over 12 months. Fourteen patients were able to proceed to further therapy. Discussion Our results reveal that receipt of immunotherapy prior to chemotherapy for metastatic melanoma does not appear to improve the benefit of chemotherapy. The palliation of symptoms, maintenance of performance status and disease control may be valuable for some patients during this time of robust research and discovery for metastatic melanoma.
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Affiliation(s)
- Elizabeth M Gaughan
- Department of Medicine, Division of Hematology and Medical Oncology, University of Virginia, Charlottesville, VA, United States
| | - Bethany J Horton
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
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10
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Yamaguma Y, Kaneuji T, Shirouzu S, Fukui T, Nakamura Y, Hirayama B, Kiyomiya H, Nagata J, Yamashita Y. Combination therapy of Mohs paste and chemotherapy improved metastatic oral cancer to the precordium skin and bilateral axillary lymph nodes: A case report. Oral Oncol 2022; 127:105817. [PMID: 35325708 DOI: 10.1016/j.oraloncology.2022.105817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 10/18/2022]
Abstract
Although Mohs paste can control bleeding, exudates, and odors from tumors, there have been no reports of the combination of Mohs paste with other treatments, such as chemotherapy, in oral cancer. Here, we report the combination of Mohs paste and chemotherapy for a case of metastatic oral cancer to the precordium skin and bilateral axillary lymph nodes. The tumors almost completely disappeared after the treatment. Combination therapy of Mohs paste and chemotherapy appears to have a better antitumor effect than Mohs paste alone.
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Affiliation(s)
- Yu Yamaguma
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Takeshi Kaneuji
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Shinichiro Shirouzu
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Takehito Fukui
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Yuri Nakamura
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Bunichi Hirayama
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Hiroyasu Kiyomiya
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Junko Nagata
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Yoshihiro Yamashita
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan.
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11
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Yasumatsu R, Shimizu Y, Hanai N, Kariya S, Yokota T, Fujii T, Tsukahara K, Ando M, Hanyu K, Ueda T, Hirakawa H, Takahashi S, Ono T, Sano D, Yamauchi M, Watanabe A, Omori K, Yamazaki T, Monden N, Kudo N, Arai M, Yonekura S, Asakage T, Nekado T, Yamada T, Homma A. Outcomes of long-term nivolumab and subsequent chemotherapy in Japanese patients with head and neck cancer: 2-year follow-up from a multicenter real-world study. Int J Clin Oncol 2021; 27:95-104. [PMID: 34773525 PMCID: PMC8732924 DOI: 10.1007/s10147-021-02047-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 09/30/2021] [Indexed: 11/25/2022]
Abstract
Background We have previously reported the effectiveness and safety of nivolumab in patients with head and neck cancer (HNC) in real-world clinical practice in Japan. Here, we report long-term outcomes from this study in the overall population and subgroups stratified by subsequent chemotherapy. Methods In this multicenter, retrospective observational study, Japanese patients with recurrent or metastatic (R/M) HNC receiving nivolumab were followed up for 2 years. Effectiveness endpoints included overall survival (OS), OS rate, progression-free survival (PFS), and PFS rate. Safety endpoints included the incidence of immune-related adverse events (irAEs). Results Overall, 256 patients received a median of 6.0 doses (range: 1–52) of nivolumab over a median duration of 72.5 days (range: 1–736). Median OS was 9.5 months [95% confidence interval (CI) 8.2–12.0] and median PFS was 2.1 months (95% CI 1.8–2.7). A significant difference between 2-year survivors (n = 62) and non-2-year survivors was observed by median age (P = 0.0227) and ECOG PS (P = 0.0001). Of 95 patients who received subsequent chemotherapy, 54.7% received paclitaxel ± cetuximab. The median OS and PFS from the start of paclitaxel ± cetuximab were 6.9 months (95% CI 5.9–11.9) and 3.5 months (95% CI 2.3–5.5), respectively. IrAEs were reported in 17.2% of patients. Endocrine (7.0%) and lung (4.3%) disorders were the most common irAEs; kidney disorder (n = 1) was newly identified in this follow-up analysis. Conclusions Results demonstrated the long-term effectiveness of nivolumab and potential effectiveness of subsequent chemotherapy in patients with R/M HNC in the real-world setting. Safety was consistent with that over the 1-year follow-up. Supplementary Information The online version contains supplementary material available at 10.1007/s10147-021-02047-y.
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Affiliation(s)
- Ryuji Yasumatsu
- Department of Otolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasushi Shimizu
- Department of Medical Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Shin Kariya
- Department of Otolaryngology, Head and Neck Surgery, Okayama University Hospital, Okayama, Japan
| | - Tomoya Yokota
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Takashi Fujii
- Department of Head and Neck Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Kiyoaki Tsukahara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Mizuo Ando
- Otorhinolaryngology and Head and Neck Surgery, The University of Tokyo Hospital, Tokyo, Japan
- Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Kenji Hanyu
- Head and Neck Oncology Center, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Tsutomu Ueda
- Department of Otorhinolaryngology, Head and Neck Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Hitoshi Hirakawa
- Department of Otorhinolaryngology, Head and Neck Surgery, University of the Ryukyus Hospital, Okinawa, Japan
| | - Shunji Takahashi
- Department of Medical Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takeharu Ono
- Department of Otolaryngology, Head and Neck Surgery, Kurume University Hospital, Kurume, Japan
| | - Daisuke Sano
- Otolaryngology, Head and Neck Surgery, Yokohama City University Hospital, Yokohama, Japan
| | - Moriyasu Yamauchi
- Department of Otolaryngology, Head and Neck Surgery, Saga University Hospital, Saga, Japan
| | - Akihito Watanabe
- Department of Otolaryngology, Head and Neck Surgery, Keiyukai Sapporo Hospital, Sapporo, Japan
| | - Koichi Omori
- Department of Otolaryngology, Head and Neck Surgery, Kyoto University Hospital, Kyoto, Japan
| | - Tomoko Yamazaki
- Division of Head and Neck Cancer Oncology, Miyagi Cancer Center, Sendai, Japan
| | - Nobuya Monden
- Department of Head and Neck Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Naomi Kudo
- Department of Otorhinolaryngology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Makoto Arai
- Department of Medical Oncology, Chiba University Hospital, Chiba, Japan
| | - Syuji Yonekura
- Department of Otorhinolaryngology, Head and Neck Surgery, Chiba University Hospital, Chiba, Japan
| | - Takahiro Asakage
- Department of Head and Neck Surgery, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan
| | | | - Takayuki Yamada
- Japan Medical and Development, Bristol-Myers Squibb K.K, Tokyo, Japan
| | - Akihiro Homma
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita15 Nishi7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
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12
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Guiard E, Clatot F, Even C, Perréard M, Abdeddaim C, Johnson A, Vauléon E, Rambeau A. Impact of previous nivolumab treatment on the response to taxanes in patients with recurrent/metastatic head and neck squamous cell carcinoma. Eur J Cancer 2021; 159:125-132. [PMID: 34743067 DOI: 10.1016/j.ejca.2021.09.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/25/2021] [Accepted: 09/19/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Immune checkpoint inhibitors are widely used in recurrent and/or metastatic head and neck squamous cell carcinoma (R/M HNSCC). We aimed to describe response rates to taxanes after progression on nivolumab in R/M HNSCC patients. METHODS In this multicentric retrospective comparative study, we included patients treated with taxane monotherapy from 2014 to 2020. Patients were divided into two groups depending on whether they received nivolumab before taxanes (post-nivolumab group) or not (control group). The primary end-point was objective response rate (ORR) comparison between the two groups. The secondary end-points included disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and PFS ratio (PFSr=PFS associated with taxanes divided by PFS associated with the previous line of treatment), a survival marker used for comparison of different treatment lines. RESULTS Between July 2014 and August 2020, 185 patients were included (114 in the control group and 71 in the post-nivolumab group). ORR was significantly higher in the post-nivolumab group (39.4% versus 26.3%, p = 0.03) as was DCR (69% versus 50%, P = 0.06). The median OS (7.5 months) and PFS (3.5 months) were not significantly different in the two groups, whereas PFSr was significantly improved in the post-nivolumab group (1.63 versus 1.11, P = 0.004). CONCLUSION Response and DCRs with taxanes are improved after prior exposure to nivolumab. Thus, taxane monotherapy could be a good choice as third-line therapy after nivolumab following a platinum-based first line. These results currently apply to patients without access to or potential benefit from first-line pembrolizumab.
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Affiliation(s)
- Emeline Guiard
- Medical Oncology Department, Centre François Baclesse, Caen, France.
| | - Florian Clatot
- Medical Oncology Department, Centre Henri Becquerel, Rouen, France
| | - Caroline Even
- Head and Neck Medical Oncology Department, Institut Gustave Roussy, Villejuif, France
| | - Marion Perréard
- Head and Neck Surgery Department, University Hospital, Caen, France
| | - Cyril Abdeddaim
- Medical Oncology Department, Centre Oscar Lambret, Lille, France
| | - Alison Johnson
- Medical Oncology Department, Centre François Baclesse, Caen, France
| | - Elodie Vauléon
- Medical Oncology Department, Centre Eugène Marquis, Rennes, France
| | - Audrey Rambeau
- Medical Oncology Department, Centre François Baclesse, Caen, France
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13
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Shaikh H, Karivedu V, Wise-Draper TM. Managing Recurrent Metastatic Head and Neck Cancer. Hematol Oncol Clin North Am 2021; 35:1009-1020. [PMID: 34226077 DOI: 10.1016/j.hoc.2021.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Head and neck squamous cell carcinoma (HNSCC) treatment is often associated with high morbidity especially in the recurrent and/or metastatic (R/M) setting, limiting effective treatment options. Local disease control is important. Therefore, local therapies including reirradiation and salvage surgery, either alone or in combination with systemic treatment, may be used for selected patients with R/M HNSCC. Although chemotherapy and targeted agents have modest efficacy in HNSCC, the advent of immunotherapy has revolutionized the treatment paradigm of R/M HNSCC. Multiple trials have resulted in the past 5 years advocating for its use alone or in combination with chemotherapy.
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Affiliation(s)
- Hira Shaikh
- Division of Hematology/Oncology, University of Cincinnati, 3125 Eden Avenue, Cincinnati, OH 45267-0562, USA
| | - Vidhya Karivedu
- Division of Medical Oncology, The Ohio State University, 1335 Lincoln Tower, 1800 Cannon Drive, Columbus, OH 43210, USA
| | - Trisha M Wise-Draper
- Division of Hematology/Oncology, University of Cincinnati, 3125 Eden Avenue, Cincinnati, OH 45267-0562, USA.
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14
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Kitamura N, Sento S, Yoshizawa Y, Sasabe E, Kudo Y, Yamamoto T. Current Trends and Future Prospects of Molecular Targeted Therapy in Head and Neck Squamous Cell Carcinoma. Int J Mol Sci 2020; 22:E240. [PMID: 33383632 PMCID: PMC7795499 DOI: 10.3390/ijms22010240] [Citation(s) in RCA: 112] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 12/17/2020] [Accepted: 12/24/2020] [Indexed: 02/06/2023] Open
Abstract
In recent years, advances in drug therapy for head and neck squamous cell carcinoma (HNSCC) have progressed rapidly. In addition to cytotoxic anti-cancer agents such as platinum-based drug (cisplatin and carboplatin) and taxane-based drugs (docetaxel and paclitaxel), epidermal growth factor receptor-tyrosine kinase inhibitors (cetuximab) and immune checkpoint inhibitors such as anti-programmed cell death-1 (PD-1) antibodies (nivolumab and pembrolizumab) have come to be used. The importance of anti-cancer drug therapy is increasing year by year. Therefore, we summarize clinical trials of molecular targeted therapy and biomarkers in HNSCC from previous studies. Here we show the current trends and future prospects of molecular targeted therapy in HNSCC.
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Affiliation(s)
- Naoya Kitamura
- Department of Oral and Maxillofacial Surgery, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan; (S.S.); (Y.Y.); (E.S.); (T.Y.)
| | - Shinya Sento
- Department of Oral and Maxillofacial Surgery, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan; (S.S.); (Y.Y.); (E.S.); (T.Y.)
| | - Yasumasa Yoshizawa
- Department of Oral and Maxillofacial Surgery, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan; (S.S.); (Y.Y.); (E.S.); (T.Y.)
| | - Eri Sasabe
- Department of Oral and Maxillofacial Surgery, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan; (S.S.); (Y.Y.); (E.S.); (T.Y.)
| | - Yasusei Kudo
- Department of Oral Bioscience, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima 770-8504, Japan;
| | - Tetsuya Yamamoto
- Department of Oral and Maxillofacial Surgery, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan; (S.S.); (Y.Y.); (E.S.); (T.Y.)
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