Response to salvage chemotherapy after progression on immune checkpoint inhibitors in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck.
Adult
Aged
Aged, 80 and over
Antibodies, Monoclonal
/ therapeutic use
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Cell Cycle Checkpoints
/ drug effects
Chemotherapy, Adjuvant
Disease Progression
Drug Resistance, Neoplasm
/ drug effects
Female
France
/ epidemiology
Head and Neck Neoplasms
/ drug therapy
Humans
Male
Middle Aged
Neoplasm Metastasis
Neoplasm Recurrence, Local
/ drug therapy
Protein Kinase Inhibitors
/ therapeutic use
Remission Induction
/ methods
Retrospective Studies
Salvage Therapy
/ statistics & numerical data
Squamous Cell Carcinoma of Head and Neck
/ drug therapy
Survival Analysis
Treatment Outcome
Young Adult
CTLA-4
Immune checkpoint inhibitor
PD-1
PD-L1
Salvage chemotherapy
Squamous cell carcinoma of head and neck
Journal
European journal of cancer (Oxford, England : 1990)
ISSN: 1879-0852
Titre abrégé: Eur J Cancer
Pays: England
ID NLM: 9005373
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
18
03
2019
revised:
22
07
2019
accepted:
26
08
2019
pubmed:
2
10
2019
medline:
9
6
2020
entrez:
2
10
2019
Statut:
ppublish
Résumé
Immune checkpoint inhibitors (ICI) are active in patients with recurrent/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). Recent data suggest that exposure to ICI improves response to salvage chemotherapy (SCT) in advanced non-small-cell lung cancer. We evaluated response to chemotherapy in patients who had progressed on ICI in patients with R/M SCCHN. A retrospective study was conducted at 4 French centres. Eligibility criteria were patients who progressed after treatment with ICI for R/M SCCHN and received SCT and for whom efficacy data were available between September 2014 and January 2018. Of 232 patients treated with ICI, 82 met eligibility criteria: 84% were male. ICI was given as monotherapy in 45% of patients or as combination in 55%. SCT included taxanes (56.1%), cetuximab in combination with taxanes or platinum (50%), platinum-based regimen (36.6%). The median number of treatment lines before SCT was 2 (range 1-6). The objective response rate (ORR) to SCT was 30%. Three patients (4%) presented complete response and 22 patients (27%) had partial response. Median progression-free survival was 3.6 months and median overall survival was 7.8 months. The age at SCT, initial tumour location, number of prior chemotherapy regimens, type of chemotherapy before ICI, best response to ICI, site of relapse and Eastern Cooperative Oncology Group at SCT were not associated with response to SCT on univariate analysis. In R/M SCCHN, the ORR to SCT was high (30%) suggesting that exposure to ICI may increase tumour sensitivity to chemotherapy.
Sections du résumé
BACKGROUND
Immune checkpoint inhibitors (ICI) are active in patients with recurrent/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). Recent data suggest that exposure to ICI improves response to salvage chemotherapy (SCT) in advanced non-small-cell lung cancer. We evaluated response to chemotherapy in patients who had progressed on ICI in patients with R/M SCCHN.
PATIENTS AND METHODS
A retrospective study was conducted at 4 French centres. Eligibility criteria were patients who progressed after treatment with ICI for R/M SCCHN and received SCT and for whom efficacy data were available between September 2014 and January 2018.
RESULTS
Of 232 patients treated with ICI, 82 met eligibility criteria: 84% were male. ICI was given as monotherapy in 45% of patients or as combination in 55%. SCT included taxanes (56.1%), cetuximab in combination with taxanes or platinum (50%), platinum-based regimen (36.6%). The median number of treatment lines before SCT was 2 (range 1-6). The objective response rate (ORR) to SCT was 30%. Three patients (4%) presented complete response and 22 patients (27%) had partial response. Median progression-free survival was 3.6 months and median overall survival was 7.8 months. The age at SCT, initial tumour location, number of prior chemotherapy regimens, type of chemotherapy before ICI, best response to ICI, site of relapse and Eastern Cooperative Oncology Group at SCT were not associated with response to SCT on univariate analysis.
CONCLUSION
In R/M SCCHN, the ORR to SCT was high (30%) suggesting that exposure to ICI may increase tumour sensitivity to chemotherapy.
Identifiants
pubmed: 31574417
pii: S0959-8049(19)30486-1
doi: 10.1016/j.ejca.2019.08.026
pii:
doi:
Substances chimiques
Antibodies, Monoclonal
0
Protein Kinase Inhibitors
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
123-129Informations de copyright
Copyright © 2019 Elsevier Ltd. All rights reserved.