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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

4370 - Clinical prognostic factors in patients (pts) with recurrent and/or metastatic (RM) head and neck carcinoma (HNC) treated with cetuximab plus chemotherapy.

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Topics

Tumour Site

Head and Neck Cancers

Presenters

Paolo Bossi

Citation

Annals of Oncology (2018) 29 (suppl_8): viii372-viii399. 10.1093/annonc/mdy287

Authors

P. Bossi1, R. Depenni2, M. cossu rocca3, D. Ferrari4, G. Azzarello5, M. Alù6, F. Nolè3, C. Codecà4, G. Boscolo5, M. Piccininni7, S. Cavalieri1, G. Pugliese8, L.F. Licitra1

Author affiliations

  • 1 Head And Neck Medical Oncology Unit, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milan/IT
  • 2 Department Of Oncology/hematology, Modena Cancer Center, 41100 - Modena/IT
  • 3 Medical Oncology, Istituto Europeo di Oncologia, 20141 - Milan/IT
  • 4 Oncology, azienda ospedaliera san paolo, milano/IT
  • 5 Oncology Unit, Department Of Internal Medical Sciences, Unita Locale Socio Sanitaria 13 P.O Mirano, 30035 - Mirano/IT
  • 6 Medical Oncology, Arnas Civico, 90127 - Palermo/IT
  • 7 Basic Medical Sciences, Neuroscience And Sense Organs, University of Bari “Aldo Moro”, Bari/IT
  • 8 Oncologia, Azienda Ospedaliero - Universitaria Policlinico di Modena, 41100 - Modena/IT
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Resources

Abstract 4370

Background

There is limited information about prognostic factors in RM HNC pts receiving first-line platinum-based chemotherapy and cetuximab. Moreover, we lack survival data in a real-world population, without the selection bias affecting pts enrolled in clinical trials.

Methods

We evaluated all consecutive pts treated from 1/2007 to 12/2016 in 6 Italian Centres. The following baseline prognostic factors were investigated: sex, age, site of disease, tumor grading, HPV status for oropharyngeal cancer, performance status (PS), weight loss in the previous 3 months (less/more than 5%), comorbidities (according to ACE-27), residual tumor at primary site, previous chemotherapy or cetuximab in curative setting, previous radiotherapy, platinum type (cisplatin/carboplatin, CBDCA), chemotherapy schedule (weekly/3-weekly), platinum and cetuximab doublet or with a third drug (i.e. 5FU or paclitaxel).

For each potential predictor variable, Kaplan-Meier curves for OS and PFS were estimated, and a Log-rank test was used to compare survivorship in different levels of the variable. A Cox proportional hazard model was run including only predictors characterized by a significant (p < 0.05) Log-rank test.

Results

We analyzed 340 pts, with a median PFS/OS of 5.0/10.6 months. The 1-year and 3-year OS rate for all pts was 44.2% (CI: 39.1-50.0) and 7.8% (CI: 5.1-12.0). Only one out of two pts received a second-line therapy. In univariate analysis lower OS was associated with PS > 0 (p < 0.001), residual tumor at primary site (p < 0.001) and CBDCA use (p = 0.012) while lower PFS was associated with paranasal sinus site (p = 0.008), PS > 0 (p = 0.001), CBDCA use (p = 0.035) and residual tumor at primary site (p < 0.001). All these predictors except for platinum type remained significant at multivariate analysis. Pts with clinical response to treatment carried a more favorable prognosis, while progressive disease as best response had a dismal median OS of 5.8 months.

Conclusions

In non-selected RM HNC pts, we obtained a median PFS and OS of 5.0 and 10.6 months, very similar to 5.6 and 10.1 months reported in Extreme trial (Vermorken et al. 2008). At baseline, PS and residual tumor at primary site could be used to define pt prognosis.

Clinical trial identification

Legal entity responsible for the study

Paolo Bossi.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

P. Bossi, D. Ferrari, R. Depenni, G. Azzarello: Advisory board: Merck Serono. L.F. Licitra: Advisory board and research support: Merck Serono. All other authors have declared no conflicts of interest.

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