학술논문

Treatment Sequences in Patients with Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: Cetuximab Followed by Immunotherapy or Vice Versa.
Document Type
Article
Source
Cancers. May2022, Vol. 14 Issue 10, p2351-N.PAG. 11p.
Subject
*THERAPEUTIC use of monoclonal antibodies
*SCIENTIFIC observation
*MULTIVARIATE analysis
*HEAD & neck cancer
*TREATMENT effectiveness
*CANCER patients
*KAPLAN-Meier estimator
*SURVIVAL analysis (Biometry)
*DESCRIPTIVE statistics
*PROGRESSION-free survival
*SQUAMOUS cell carcinoma
*IMMUNOTHERAPY
Language
ISSN
2072-6694
Abstract
Simple Summary: As the treatment advances, there were several novel agents developed for R/M HNSCC, including an anti-epidermal growth factor receptor antibody, cetuximab, and an anti-programmed death-1 immune checkpoint inhibitor, pembrolizumab and nivolumab. To date, little was known regarding the optimal treatment sequences. Our observational study demonstrated that median overall survival was 23.7 months versus 22.8 months in Cet-IO and IO-Cet, respectively (p = 0.484). The overall response rate (ORR) were 73% in Cet-IO versus 37% in IO-Cet (p = 0.002). Both Cet-IO and IO-Cet are effective in R/M HNSCC patients with insignificant survival differences. The higher response rate of Cet-IO might render it to be considered in patients with large tumor burdens and urgent needs for treatment responses. Our conclusion can be real-world evidence for clinical decision-making. Background: The prognosis was poor when patients had recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). Herein, we conducted an observational study of cetuximab followed by immunotherapy (Cet-IO) versus immunotherapy followed by cetuximab (IO-Cet) in patients with R/M HNSCC. Methods: Patients who were diagnosed with R/M HNSCC and treated with a sequential cetuximab-containing regimen and immunotherapy-containing regimen were enrolled in our study. Kaplan-Meier curves were estimated for progression-free survival (PFS) and overall survival (OS). Results: A total of 75 patients were enrolled in our study for oncologic outcomes evaluation, with 40 patients in Cet-IO and 35 patients in IO-Cet. The median PFS1 was 5.1 months in Cet-IO and 4.5 months in IO-Cet (p = 0.777) and the median PFS2 was 16.5 months in Cet-IO and 11.4 months in IO-Cet (p = 0.566). The median OS was 23.7 months versus 22.8 months in Cet-IO and IO-Cet, respectively (p = 0.484). The overall response rate (ORR) were 73% in Cet-IO versus 37% in IO-Cet (p = 0.002). Multivariate analysis demonstrated that the treatment sequences, Cet-IO or IO-Cet, were insignificantly different with survival. Conclusion: Both Cet-IO and IO-Cet are effective in R/M HNSCC patients with insignificant survival differences. The higher ORR of Cet-IO might render it to be considered in patients with large tumor burdens and urgent needs for treatment responses. Further prospective studies are merited to validate our conclusions. [ABSTRACT FROM AUTHOR]