Abstract 441P
Background
Immunotherapy (IT) in recurrent or metastatic head and neck squamous cell cancer (R/MHNSCC) was anticipated to show considerable impact on survival and has started to be widely used in clinical practice. Analysis of real-world experience is warranted to determine the role of IT in later lines of therapy.
Methods
We retrospectively reviewed medical data of patients (pts) with R/MHNSCC of oral cavity, oropharynx, hypopharynx, larynx or maxillary sinus cancer, who started IT in second or later lines of therapy since May 2018 to August 2023. Progression free survival (PFS) and overall survival (OS) were assessed. Cox regression model was used to evaluate the value of other prognostic variables including PD-L1 expression status, previous receipt of cetuximab (yes or no) and performance status (PS).
Results
A total of 137 pts were identified. All of them received IT with nivolumab for treatment of R/MHNSCC after platinum-based therapy. The median age was 61 years (range, 36 to 83 years). The median duration of follow-up was 26.0 months. The median PFS was 3.0 months (95% CI, 2.2 – 3.8), the median OS - 8.0 months (95% CI, 5.1 - 10.9). The 1-year survival rate was 13.1 %. After 2 years only 4.3 % of pts remained alive. Tumor PD-L1 expression status was evaluated in 45 (32.0%) pts. Median OS for pts with PD-L1 positive tumors was 11.0 months (95% CI, 5.6 - 16.4) vs 6.0 months (95% CI, 4.0 - 8.0) for those with PD-L1 negative tumors (HR 1.3; 95% CI, 0.7 - 2.8; p = 0.380). For patients without prior cetuximab exposure median OS was 19.0 months, while mOS of cetuximab-treated pts was 5.0 months (HR 0.4; 95% CI, 0.3 - 0.6; p = 0.005). ECOG (Eastern Cooperative Oncology Group) PS 2 was associated with worse OS (HR = 0.4, CI, 0.2 to 0.8; P = 0.007).
Conclusions
Nivolumab appears to have moderate influence on survival rates in our single-center population. These results are comparable to CHECKMATE-141. But small amount of exceptional responders questions feasibility of using IT as monotherapy.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.