Weekly chemotherapy as first line treatment in frail head and neck cancer patients in the immunotherapy era.
Cetuximab
Chemotherapy
Docetaxel
First line
Frail patient population
Head and neck cancer
Journal
Journal of translational medicine
ISSN: 1479-5876
Titre abrégé: J Transl Med
Pays: England
ID NLM: 101190741
Informations de publication
Date de publication:
12 07 2021
12 07 2021
Historique:
received:
18
05
2021
accepted:
02
07
2021
entrez:
13
7
2021
pubmed:
14
7
2021
medline:
6
8
2021
Statut:
epublish
Résumé
First-line therapy for metastatic squamous cell carcinoma of the head and neck (R/M HNSCC) has been revolutionized by the introduction of anti-checkpoint monoclonal antibodies, which have shown a significant improvement in overall survival (OS) gaining approval in a first line setting. Efficacy and safety of first-line weekly chemotherapy, compared to 3-weeks treatment, was retrospectively evaluated in a frail patient population with R/M HNSCC with the aim to evaluate its role as part of a personalized first-line approach. A total of 124 patients with locally incurable R/M HNSCC receiving weekly (21) or three-weekly (103) chemotherapy plus cetuximab in a first line setting from December 2010 to September 2020 were retrospectively reviewed. Treatment outcomes in terms of objective response rate (ORR), progression-free survival (PFS), overall survival (OS) and toxicities were analysed. Patients in the three-week subgroup were ECOG PS 0 (39) and 1 (64) while patients in weekly group (21) were all PS 2. No significant differences were reported in terms of age, sex, smoking and previous alcohol abuse considering the two distinct subgroups. Moreover, no statistically significant difference was found in PFS and OS between the two treatment subgroups. The response rate was 35% (36 patients) and 34% (7 patients) in three-week and weekly treatment group, respectively. Seventy patients (68%) in the three-week group experienced chemotherapy-related toxicities, predominantly G3. In the weekly group a predominantly low-grade toxicity was found in a lower number of patients (52%). The weekly schedule appears to be an active and safe strategy in frail patients with R/M HNSCC. Based on these data, a weekly schedule could be considered as a first line treatment in all frail patients excluded from pembrolizumab treatment and a study on the combination of weekly chemotherapy and immunotherapy should be performed.
Identifiants
pubmed: 34253248
doi: 10.1186/s12967-021-02975-3
pii: 10.1186/s12967-021-02975-3
pmc: PMC8274020
doi:
Substances chimiques
Cetuximab
PQX0D8J21J
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
303Informations de copyright
© 2021. The Author(s).
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