Abstract 384P
Background
Betel nut chewing might contribute to strong invasion and treatment refractoriness. In western countries where HPV+ OPC prevalence is high, induction TPF response rate in locally advanced HNSCC is around 70%; Erbitux and TP (Argiris in JCO2008) response rate is 86%. In the analysis from KGMH in Taiwan, induction response for locally advanced HNSCC was 55% in betel-nuts chewers compared with 75% in non-users(p=0.038; From Su in World Journal of Surgical Oncology 2016). Erbitux-TPF induction response rate was 88% from VGH in Taiwan by Lu in Head & Neck2019. In our previous study from unresectable stage IVA & IVB betal-nuts related HNSCC patients in ASCO2023, flexible chemotherapy backbones, such as TP/DP-HDFL(weekly docetaxel or paclitaxel with cisplatin and 24-hr high dose 5-fluorouracil/leucovorin infusion) with Biotherapy(EGFR or VEGFR-targeting)or Bio-immunotherapy had encouraging induction response with favorable toxicity to conversion surgery or definite CCRT.
Methods
Hypopharyngreal cancer in Taiwan in Taiwan often had advaced stage(stage IV 70%) and double cancers easily(esp. lung cancer and esophageal cancer). We prepared to compare the outcomes of different treatment strategies in stage IVA/IVB hypophryngeal cancer, from 2012 to 2023.
Results
Table: 384P
Treatment strategies(total 75 patients) | Definite CCRT 9 | Curative surgery then adjuvant CCRT 14(all receiving total laryngectomy & bilateral neck dissection) | Induction therapy then definite CCRT 29 | Induction therapy then curative surgery then adjuvant CCRT 23 |
Induction response(total 52 patients) | N/A | N/A | 69%(20/29) | 87%(20/23) |
2-year DFS(total 64 patients) | 57.1% | 63.6% | 68% | 81% |
5-year OS(total 50 patients) | 20% | 26.7% | 37.5% | 50% |
All with maintenance UFUR
Conclusions
CCRT is still one standard option; if no need for organ preservation, curative surgery followed by adjuvant CCRT still works in resectable and medically operable patients. Maintenance UFUR yielded relatively favorable 2-year DFS and 5-year OS. Induction Bio-CT or Bio-chemoimmunotherapy followed by CCRT may be promoted beyond TAX323/324. Aggressive induction therapy followed by mini-invasive surgery and then adjuvant CCRT with maintenance UFUR might be administered in selected patients with high induction response. Encouraging outcomes have been shown by sequential multi-modality strategies for locally advanced betel-nuts related hypopharyngeal cancer in Taiwan.
Clinical trial identification
N/A
Editorial acknowledgement
Legal entity responsible for the study
Institutional Review Board in National Taiwan University Hospital.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
203P - Neoadjuvant durvalumab plus chemotherapy for resectable locally advanced esophageal squamous cell carcinoma (ESCC)
Presenter: Jia He
Session: Poster Display
Resources:
Abstract
204P - A radiomics strategy based on CT intra-tumoral and peritumoral regions for preoperative prediction of neoadjuvant chemoradiotherapy for esophageal cancer
Presenter: zhiyang li
Session: Poster Display
Resources:
Abstract
205TiP - IMPACT: Randomized, multicenter, phase III study evaluating the efficacy of immunotherapy (atezolizumab) plus anti-VEGF therapy (bevacizumab) in combination with transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma (HCC)
Presenter: Tatsuya Yamashita
Session: Poster Display
Resources:
Abstract
206TiP - SIERRA: A phase IIIb, single-arm, multicentre study of tremelimumab plus durvalumab for first-line treatment of advanced unresectable hepatocellular carcinoma
Presenter: Stephen Chan
Session: Poster Display
Resources:
Abstract
207TiP - A two-arm randomized open-label prospective design superiority phase III clinical trial to compare the efficacy of docetaxel-oxaliplatin-capecitabine/ 5 -fluorouracil (DOC/F) followed by docetaxel versus CAPOX/mFOLFOX-7 in advanced gastric cancers
Presenter: Prabhat Bhargava
Session: Poster Display
Resources:
Abstract
212P - Mutational landscape and characteristics of ERBB2 in urothelial carcinoma
Presenter: Mingwei Li
Session: Poster Display
Resources:
Abstract
213P - Prognostic significance of absolute lymphocyte count in patients with metastatic renal cell carcinoma treated with first-line combination immunotherapies: Results from the International metastatic renal cell carcinoma database consortium (IMDC)
Presenter: Kosuke Takemura
Session: Poster Display
Resources:
Abstract
214P - Development and prospective validation of a multiplex RNA urine test for noninvasive detection and surveillance of urothelial carcinoma
Presenter: Hua Xu
Session: Poster Display
Resources:
Abstract
215P - Real-world outcomes of first-line tislelizumab plus axitinib in patients with metastatic non-clear cell renal cell carcinoma (mnccRCC)
Presenter: Pei Dong
Session: Poster Display
Resources:
Abstract
216P - Preliminary efficacy and safety results from ‘ReBirth’: A phase II study of risk-based bladder-sparing therapy for MIBC
Presenter: Yijun Shen
Session: Poster Display
Resources:
Abstract