Background. There are still few data on the activity and safety of cetuximab-based salvage chemotherapy after immunotherapy (SCAI) in patients with squamous cell cancer of the head and neck (SCCHN). Materials and Methods. Retrospective study of patients with SCCHN who received cetuximab-based SCAI after PD1 or PDL1 (PD(L)1) inhibitors. Overall response rate (ORR) and disease control rate (DCR) with SCAI and with last chemotherapy before immunotherapy (LCBI) by RECIST 1.1, percentage change from baseline in target lesions (PCTL), progression-free survival (PFS), overall survival (OS), treatment compliance and toxicity were evaluated. Results. Between March 2016 and November 2019, 23 patients were identified. SCAI consisted of cetuximabbased combinations (3wkCDDP-5FU-Cetuximab (n=2), wkPaclitaxel-Cetuximab (n=17), wkCDDP-Cetuximab (n=2), wkCBDCA-Paclitaxel-Cetuximab (n=2)). ORR was 56.5% (11 partial response (PR), 2 complete response (CR)). DCR was 78.3%. Among 13 objective responders, median best PCTL was-53.5% (range:-30% to-100%). Median OS and PFS were 12m and 6m, respectively. In 10 patients receiving LCBI, ORR to LCBI was 40%, while ORR to SCAI achieved 60%. In LCBI-treated patients median PFS with LCBI was 8m and median PFS and OS with SCAI were 7m and 12m, respectively. Reduced dose intensity of the chemotherapy and cetuximab components occurred in 82.6% and 52.2% of the patients. Grade 1 or 2 AEs occurred in all patients. Grade 3 or 4 AEs developed in 65%, being grade 3 in all of them except in one patient (grade 4 neutropenia). There were no treatment-related deaths. Conclusion. Cetuximab-based salvage chemotherapy after PD(L)1 inhibitors associated with high response rates and deep tumor reductions with a manageable safety profile. Subsequent lines of therapy may explain the long survival achieved in our series. These results invite to design studies to elucidate the best therapeutic sequence in patients with SCCHN in the immunotherapy era. The Oncologist 2021;9999:• • Implications for Practice: Cetuximab-based salvage chemotherapy (SCAI) achieved high response rates in patients with R/M SCCHN after progression to PD1/PDL1 inhibitors. Objective response rate was higher and progression-free survival was comparable to that of chemotherapy administered before immunotherapy (IO). In most patients, SCAI consisted of weekly, welltolerated regimens. These observations have implications for current practice due to the limited evidence to date in SCCHN and the scant therapeutic options in this disease, and invite to elucidate which may be the best treatment sequence for head and neck cancer patients in the IO era.

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Purpose: To assess the correlation between optical coherence tomography (OCT) and magnetic resonance imaging (MRI) measurements of extraocular rectus muscle thickness in patients with Graves' ophthalmopathy. Methods: This was a cross-sectional observational study conducted in 62 eyes of 31 patients with Graves' ophthalmopathy. The disease phase was inactive in 20 patients and active in the remaining 11. The OCT measurements obtained were: medial rectus thickness at 7.2 and 9.2 mm from the limbus and lateral rectus thickness at 8.5 mm from the limbus. MRI measurements were maximum transversal diameter (T-MRI), craniocaudal diameter (CC-MRI), and muscle area (A-MRI). Results: For the whole patient cohort, correlation emerged between the OCT-MR and T-MRI measurements ( R = 0.428 to 0.576; P ≤ .002), A-MRI ( R = 0.562 to 0.674; P < .001), and CC-MRI ( R = 0.286 to 0.293; P ≤ .046). In patients with clinically active Graves' ophthalmopathy, correlations with T-MRI ( R = 0.576 to 0.604; P ≤ .010) and A-MRI ( R = 0.678 to 0.706; P < .001) were higher. No correlations were detected between OCT and MRI measurements of lateral rectus thickness ( P ≥ .177), regardless of disease phase. Conclusions: The correlations observed suggest OCT could be a complementary assessment or screening method to detect thickening of the anterior portion of the medial rectus muscle in patients with Graves' ophthalmopathy, which may be especially useful when MRI is not available. [ J Pediatr Ophthalmol Strabismus . 2019;56(5):319–326.]

Up to 10–15% of patients with first-line recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) present with platinum-refractory disease. The anti-PD1 nivolumab is the first therapeutic option in this setting achieving a 19.2% objective response rate and a 7.7-month median overall survival (OS). Given the poor prognosis of platinum-refractory patients, those showing slow progressive disease with no functional status deterioration should maintain nivolumab beyond progression in the absence of severe or unmanageable toxicities. Another strategy is to use local therapies such as radiotherapy and surgical tumor resection in cases of oligometastatic or oligoprogressive disease. Both strategies may significantly improve disease control and OS in these populations. We present the case of a patient with platinum-refractory disease treated with first-line nivolumab beyond progression who achieved a durable complete response after palliative radiation and surgical resection of five tumor lesions. To our knowledge, this is the first reported case of an R/M HNSCC treated with such a strategy outside a clinical trial and contributes to the evidence for combining anti-PD1 agents and local therapies in selected patients with R/M HNSCC.

after ICI. Nevertheless, taxane appears to have modest effectiveness in pre-treated patients. We aimed to assess survival outcomes with taxane chemotherapies after ICI exposure and to identify prognostic and predictive factors that may influence response to those regimen. Methods:In this multicentric retrospective study, we included patients with stage IIIB or higher NSCLC who received subsequently taxane after ICI failure. Primary end points were progression-free survival on taxane (Taxane PFS) and overall survival on taxane (Taxane OS). Secondary end points were Taxane PFS to ICI PFS ratio to evaluate benefit of subsequent taxane and identification of clinical data associated with better survival on taxane.Results: We included 110 patients, mostly men (71.8 %) with a median age of 63. Patients mostly had stage IVB (65.5%) and adenocarcinoma was the predominant histologic subtype (59.1%). Docetaxel was the taxane chosen in 70% of cases. Median Taxane PFS was 3.6 months (2.7-4.8) and Taxane OS was 7.3 months (6.1-10.3). Only 36.9% of patients had a ratio Taxane PFS to ICI PFS greater than 1.3 without clinical difference in this subgroup, except for age (60.2 versus 63.9; p¼0,021). A number of 6 or above ICI cycles was an independent prognostic factor for better Taxane PFS and OS. Similarly, in multivariate model, performans status at 2 or higher (PS 2) and a 2g/dL loss of haemoglobin between the end of ICI and taxane initiation were associated with poorer Taxane OS. Only PS 2 was associated with a poorer Taxane PFS.Conclusions: Effectiveness of further treatment with taxane after ICI failure was observed only in a limited subgroup of patients. Factors associated with good health condition and a long exposure to ICI appeared to be predictive of better survival on taxanes.Legal entity responsible for the study: Institut de cancérologie de l'ouest.