Advanced and metastatic head and neck (HN) cancers are a heterogeneous tumour with poor outcome as few therapeutic options are available. Until now, no accepted genomic profiles can lead to an oriented treatment. We performed a retrospective analysis of the MOSCATO-01 trial for patients with advanced and metastatic HN cancer.
Patients included in MOSCATO-01 trial underwent biopsies for molecular screening analyses by Comparative Genomic Hybridisation Array, Next Generation Sequencing or RNA Seq. Patients were treated by targeted treatment on the molecular alteration screening. Progression-free survival (PFS) ratio was the primary endpoint corresponding to PFS2/PFS1 (PFS2: PFS in patients treated according to molecular alteration; PFS1: PFS in patients treated with usual treatment).
129 patients (12.4%) with advanced or metastatic HN cancers were included in MOSCATO-01 trial among 1035 patients. The most frequent histologic type was squamous cell carcinoma (62.7%), followed by adenocarcinoma and kystic adenoid carcinoma (6.5% each) and muco epidermoid carcinoma (3.7%). Patients were in most of the cases heavily pre-treated, as 65% of them received 3 lines of prior systemic treatment. More than 60% of the patients had a RMH score at 0. Of 107 patients (82.9%) who underwent a biopsy, 45 (42%) presented potential targetable molecular alterations: PI3KCA, ERBB2, NOTCH and MET where the most frequent targeted molecular alterations. Moreover, 33.3% of them (n = 15) had a targeted treatment: 9 patients in phase 1 trial and 6 with off label use therapeutic. The median progression free survival of the 15 patients treated according to molecular alteration was 1.7 months [0.26-6.93]. The PFS ratio was above 1.3 for 46% of the patients.
MOSCATO-01 for HN cancers showed that a large proportion of patients have cancer with actionable molecular alteration, with benefit on PFS ratio of oriented treatment guided by molecular screening. Precision medicine in advanced HN cancers could bring new therapeutic options in these hard to treat cancers.
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All authors have declared no conflicts of interest.