LBA4 - Patient-reported outcomes (PROs) in recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN) treated with nivolumab (nivo...

Date 09 October 2016
Event ESMO 2016 Congress
Session Presidential Symposium 2
Topics Head and Neck Cancers
Presenter Kevin Harrington
Citation Annals of Oncology (2016) 27 (6): 1-36. 10.1093/annonc/mdw435
Authors K. Harrington1, R.L. Ferris2, J. Shaw3, F. Taylor4, M. Derosa4, D. Turner-Bowker4, L. Morrissey4, K. Cocks5, N. Kiyota6, M. Gillison7, J. Guigay8
  • 1Division Of Radiotherapy And Imaging, Institute of Cancer Research ICR, SW7 6JB - London/GB
  • 2Division Of Head And Neck Surgery Departments Of Otolaryngology, University of Pittsburgh Cancer Institute, 15213 - Pittsburgh/US
  • 3Clinical Outcomes Assessment And I-o Lcm Worldwide Health Economics And Outcomes Research, Bristol-Myers Squibb, Princeton/US
  • 4Patient-centered Outcomes, Adelphi Values, Boston/US
  • 5Patient-centered Outcomes, Adelphi Values, Cheshire/GB
  • 6Medicine Of Oncology, Kobe University Hospital, Kobe/JP
  • 7Internal Medicine, College Of Medicine, The Ohio State University, 43202 - Columbus/US
  • 8Medical Oncology Department, Centre Antoine Lacassagne, 06100 - Nice/FR

Abstract

Background

Patients (pts) with platinum-refractory R/M SCCHN have median survival ≤6 mo and suffer from their disease and its treatment. Accordingly, maintaining quality of life (QoL) is a key treatment goal. PRO data were collected as exploratory endpoints in CheckMate 141 (NCT02105636), a randomized, open-label, phase 3 trial comparing nivo to IC (methotrexate, docetaxel, or cetuximab) in 361 pts with platinum-refractory R/M SCCHN. We report the first comparative results for PRO for nivo and IC in R/M SCCHN.

Methods

The European Organisation for Research and Treatment of Cancer QoL Questionnaire (EORTC QLQ-C30), EORTC Head and Neck Cancer module (QLQ-H&N35), and EQ-5D were administered at baseline (BL), wk 9, and then at 6-wk intervals during treatment. A clinically relevant score change or difference was regarded as 10 points for the EORTC subscales. Analysis of covariance (ANCOVA) was applied to compare mean score changes between arms. Proportional hazards regression was used to evaluate time to clinically relevant score deterioration (TTD).

Results

BL questionnaire completion rates for nivo and IC were ∼80% and ∼75%, respectively. Low IC completion rates precluded analysis of mean differences after wk 15. Overall, 129 pts completed a PRO measure at BL and during follow up. Nivo significantly delayed TTD (P < 0.05, 2-tailed) vs IC for global health; physical, role, cognitive, and social functioning; fatigue; dyspnea; and insomnia (EORTC QLQ-C30) as well as pain; sensory problems; and mouth opening problems (QLQ-H&N35). ANCOVA revealed statistically significant, clinically relevant differences favoring nivo at wks 9 and 15 for role and social functioning, fatigue, dyspnea, and appetite loss (EORTC QLQ-C30) as well as pain and sensory problems (QLQ-H&N35). Differences in mean values were observed for other PROs at wk 15 only.

Conclusions

Pts treated with nivo had delayed worsening of functioning and symptoms with PRO differences between arms favoring nivo up to ∼4 mo of follow up. These results, as assessed through wk 15, suggest that pts receiving nivo maintained functioning for longer and had less pain, fatigue, and dyspnea on treatment as compared with IC.

Clinical trial identification

NCT02105636; Study start date, May 2014

Legal entity responsible for the study

Sponsored by Bristol-Myers Squibb

Funding

Bristol-Myers Squibb

Disclosure

K. Harrington: Personal fees and fees paid to research institution from BMS, during the study; Fees paid to research institution by AstraZeneca and Pfizer; Personal fees and fees paid to research institution from Merck and Amgen, outside submitted work. R.L. Ferris: Grants and consulting/advisory board member for AstraZeneca, Merck, and BMS; Consulting/advisory board member for Pfizer. J. Shaw: Employee and shareholder of Bristol-Myers Squibb. F. Taylor: Employee of Adelphi Values, a consulting firm paid by BMS to analyze clinical trial PRO data D. Turner-Bowker: Employee of Adelphi Values, which received funding to conduct this research. L. Morrissey: Employee of Adelphi Values, which was paid for the statistical analyses. K. Cocks: Employee of Adelphi Values, which is a paid consultant of BMS. N. Kiyota: Grants & personal fees from ONO Pharmaceutical Co, Ltd, during the study; Grants from Eisai Co, Ltd, and Nippon Boehringer Ingelheim Co, Ltd, outside submitted work; Payment for seminar participation from BMS, Merck Serono, and Bayer. M. Gillison: Consulting for BMS, Lilly, and Merck Inc. J. Guigay: Grants from and advisory board member for Merck; Grants from GSK; Advisory board member for BMS and Innate Pharma All other authors have declared no conflicts of interest.