First-line versus second-line immunotherapy in recurrent/metastatic squamous cell carcinoma of the head and neck

Even, Caroline; Torossian, Nouritza; Ibrahim, Tony; Martin, Nicolas; Badis, L. Mayache; Ferrand, François‐Régis; Iacob, Mariana; Guigay, J.; Tourneau, Christophe Le; Daste, Amaury; Sâada-Bouzid, Esma; Saleh, Khalil

doi:10.1093/annonc/mdz252.030

Cited by 5 publications

(7 citation statements)

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“…This is in line with recent pharmacological findings suggesting that at a mechanistical level, clinical efficacy of many combination regimens is conferred by independent drug action without interaction (i.e., without additivity or synergy) (18). Indeed, the efficacy seems to be preserved or even improved with sequential versus simultaneous treatment and the risks of premature progression or immune-related side-effects reduced (4,19). In this respect, the choice of first-line cytotoxics, such as taxanes, may play an important role (20).…”

Section: Pros and Cons Of Immunotherapysupporting

confidence: 87%

Translating KEYNOTE-048 into practice recommendations for head and neck cancer

Szturz¹,

Vermorken

2020

Ann Transl Med

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Section: Pros and Cons Of Immunotherapysupporting

confidence: 87%

Translating KEYNOTE-048 into practice recommendations for head and neck cancer

Szturz¹,

Vermorken

2020

Ann Transl Med

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“…Real-world studies of immunotherapy after platinum-based chemotherapy reported similar activity to that of phase 3 trials, with a median OS that ranged from 6.5 to 8.7 months ( 17 , 18 ). Only one previous real-world study with SCCHN patients who received immunotherapy as second-line therapy reported a prolonged median OS of 22.1 months in line with our results ( 19 ). DoR and survival were substantially longer in those who received immunotherapy after first-line chemotherapy, suggesting a potential boosting effect of previous chemotherapy ( 19 ).…”

Section: Discussionsupporting

confidence: 91%

“…Only one previous real-world study with SCCHN patients who received immunotherapy as second-line therapy reported a prolonged median OS of 22.1 months in line with our results ( 19 ). DoR and survival were substantially longer in those who received immunotherapy after first-line chemotherapy, suggesting a potential boosting effect of previous chemotherapy ( 19 ). Despite their poor prognosis, we achieve that a percentage of patients, although low, can benefit from subsequent lines and improve survival.…”

Section: Discussionsupporting

confidence: 91%

TTCC-2019-02: real-world evidence of first-line cetuximab plus paclitaxel in recurrent or metastatic squamous cell carcinoma of the head and neck

Rubió-Casadevall,

Cirauqui Cirauqui,

Martinez Trufero

et al. 2023

Front. Oncol.

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ObjectivesThe aim of this study was to confirm the efficacy of the ERBITAX scheme (paclitaxel 80 mg/m2 weekly and cetuximab 400 mg/m2 loading dose, and then 250 mg/m2 weekly) as first-line treatment for patients with recurrent/metastatic squamous cell carcinoma of the head and neck (SCCHN) who are medically unfit for cisplatin-based (PT) chemotherapy.Materials and methodsThis retrospective, non-interventional study involved 16 centers in Spain. Inclusion criteria were to have started receiving ERBITAX regimen from January 2012 to December 2018; histologically confirmed SCCHN including oral cavity, oropharynx, hypopharynx, and larynx; age ≥18 years; and platinum (PT) chemotherapy ineligibility due to performance status, comorbidities, high accumulated dose of PT, or PT refractoriness.ResultsA total of 531 patients from 16 hospitals in Spain were enrolled. The median age was 66 years, 82.7% were male, and 83.5% were current/former smokers. Patients were ineligible to receive PT due to ECOG 2 (50.3%), comorbidities (32%), PT cumulative dose ≥ 225 mg/m2 (10.5%), or PT refractoriness (7.2%). Response rate was 37.7%. Median duration of response was 5.6 months (95% CI: 4.4–6.6). With a median follow-up of 8.7 months (95% CI: 7.7–10.2), median PFS and OS were 4.5 months (95% CI: 3.9–5.0) and 8.9 months (95% CI: 7.8–10.3), respectively. Patients treated with immunotherapy after ERBITAX had better OS with a median of 29.8 months compared to 13.8 months for those who received other treatments. The most common grade ≥ 3 toxicities were acne-like rash in 36 patients (6.8%) and oral mucositis in 8 patients (1.5%). Five (0.9%) patients experienced grade ≥ 3 febrile neutropenia.ConclusionThis study confirms the real-world efficacy and tolerability of ERBITAX as first-line treatment in recurrent/metastatic SCCHN when PT is not feasible. Immunotherapy after treatment with ERBITAX showed remarkable promising survival, despite potential selection bias.

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“…If for the same reasons, we must remain cautious about the possible extrapolation of these results, we can reasonably wonder about the particular place of the taxane-anti-PD1 interaction in this situation, as well as a possible positive interaction of cetuximab and anti-PD-1 [30]. Additionally, a large retrospective study was conducted in France [31] with the aim to compare the efficacy of immune checkpoint inhibitors (ICI) used as first line versus second line in RM HNSCC to define the best treatment strategy. One hundred and ninetytwo patients were included in this study: 57 patients (30%) received ICI as first-line treatment (G1) and 135 patients (70%) as second-line setting (G2).…”

Section: What Is the Best Therapy Sequencing To Maximize The Overall ...mentioning

confidence: 99%

“…Additionally, a large retrospective study was conducted in France [31] with the aim to compare the efficacy of immune checkpoint inhibitors (ICI) used as first line versus second line in RM HNSCC to define the best treatment strategy. One hundred and ninety-two patients were included in this study: 57 patients (30%) received ICI as first-line treatment (G1) and 135 patients (70%) as second-line setting (G2).…”

Section: What Is the Best Therapy Sequencing To Maximize The Overall ...mentioning

confidence: 99%

Systemic treatment of recurrent and/or metastatic squamous cell carcinomas of the head and neck: what is the best therapeutic sequence?

Sâada-Bouzid

Peyrade

Guigay

2022

Current Opinion in Oncology

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Purpose of reviewThe treatment of recurrent and/or metastatic head and neck squamous cell carcinoma patients is revolutionized by the advent of anti-PD1 checkpoint inhibitors. Recent findingsIndeed, Pembrolizumab is approved as monotherapy or used in combination with platin and fluorouracil for first-line patients with tumors expressing PD-L1. Nivolumab and Pembrolizumab are also approved in second line of recurrent/metastatic head and neck squamous cell carcinoma. Moreover, the substitution of fluorouracil for a taxane in the TPEx regimen has shown improvement in safety profile when compared with EXTREME regimen.

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First-line versus second-line immunotherapy in recurrent/metastatic squamous cell carcinoma of the head and neck

Cited by 5 publications

References 0 publications

Translating KEYNOTE-048 into practice recommendations for head and neck cancer

Translating KEYNOTE-048 into practice recommendations for head and neck cancer

TTCC-2019-02: real-world evidence of first-line cetuximab plus paclitaxel in recurrent or metastatic squamous cell carcinoma of the head and neck

Systemic treatment of recurrent and/or metastatic squamous cell carcinomas of the head and neck: what is the best therapeutic sequence?

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