Abstract 3985
Background
Oral cavity and oropharyngeal squamous cell cancers (OC-OPSCC) display high cancer mortality. Aspiration, infection, other complications or treatment, and age- and substance-related comorbidities contribute to non-cancer mortality. This single-institution study examines cause of death in patients treated for OC-OPSCC with brachytherapy, chemotherapy, external beam radiation, surgery, or combination of modalities. We hypothesize that brachytherapy results in lower non-cancer mortality.
Methods
IRB approval was obtained. Our institution’s Tumor Registry and electronic medical record were used to identify patients with a first OC-OPSCC diagnosis between 2000-2010. Patients with a second primary cancer at diagnosis were excluded. The primary outcome was association between treatment modality and non-cancer mortality. Secondary outcomes were effects of comorbidities on death, specific causes of non-cancer mortality, and cancer mortality.
Results
Of 693 eligible patients, 460 were deceased. 84 died of the primary malignancy. Non-primary cancer cause of death was determined in 96 patients; 24 died from a second primary. 193 patients received brachytherapy. Cox proportional hazards regression was performed on treatment regimen, exposures, and non-cancer mortality, stratified by AJCC stage, race, and sex. Age, smoking, and alcohol were associated with worse survival, with HRs of 1.03 (p < 0.005), 1.36 (p < 0.11), and 2.23 (p < 0.005), respectively. Brachytherapy had a notable 0.52 HR (p < 0.005). Non-smoking OPC patients had a 76% 5-year overall survival (OS), suggesting these were largely HPV-driven cancers. In smokers with OPC, OS was 33% at 5 years, with a HR of 0.35 for brachytherapy-treated patients.
Conclusions
We report non-cancer mortality from an extensively annotated cohort of curatively treated OC-OPSCC. We show a significant correlation between receipt of brachytherapy and non-cancer survival, independent of remission status. Potential explanations include improved disease control, patient selection, and reduced exposure to external beam radiation. Although HPV status was not available, OPC in non-smokers displayed OS characteristic for HPV-associated cancer. The impact of brachytherapy in OPC was strongest in smokers.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
S. Mehra: Research grant / Funding (institution): DePuy Synthes Educational Grant for Yale Head and Neck Surgery Fellowship. B. Burtness: Advisory / Consultancy: Aduro; Advisory / Consultancy: Alligator Biosciences; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Boehringer Ingelheim; Advisory / Consultancy: Bristol-Myers Squibb; Advisory / Consultancy: Celgene; Advisory / Consultancy: Cue Biopharma; Advisory / Consultancy: Genentech/Roche; Advisory / Consultancy: Glaxo Smith Kline; Advisory / Consultancy: IDDI; Advisory / Consultancy: Merck. All other authors have declared no conflicts of interest.
Resources from the same session
2421 - Lenvatinib plus PD-1 blockade in advanced bile tract carcinoma.
Presenter: Jianzhen Lin
Session: Poster Display session 3
Resources:
Abstract
5368 - Durvalumab and Paclitaxel Combination for treatment of metastatic triple negative breast cancer is safe with very promising efficacy
Presenter: Hazem Ghebeh
Session: Poster Display session 3
Resources:
Abstract
1520 - A prospective cohort study on the pharmacokinetics of nivolumab in metastatic non-small cell lung cancer, melanoma, and renal cell cancer patients
Presenter: Daan Hurkmans
Session: Poster Display session 3
Resources:
Abstract
1603 - Safety and clinical activity of subcutaneously (SC) administered anti-PD-1 antibody PF-06801591 in phase I dose-expansion cohorts of locally advanced or metastatic non-small-cell lung cancer (NSCLC) and urothelial carcinoma (UC)
Presenter: Byoung Cho
Session: Poster Display session 3
Resources:
Abstract
3922 - Development of the Functional Assessment of Cancer Therapy-Immune Checkpoint Modulator (FACT-ICM): A scale to measure quality of life in cancer patients treated with ICMs
Presenter: Aaron Hansen
Session: Poster Display session 3
Resources:
Abstract
2408 - Immune checkpoint inhibitors (ICIs) as “chemotherapy (Ctx) sensitization” strategy in advanced solid tumors
Presenter: Francisco Javier Ros Montana
Session: Poster Display session 3
Resources:
Abstract
3612 - Validation of progression-free survival (PFS) as surrogate endpoint in randomised trials of immune checkpoint inhibitors in advanced solid cancers
Presenter: Peey Sei Kok
Session: Poster Display session 3
Resources:
Abstract
3827 - Pharmacokinetic (PK) analysis of weight-based and fixed dose cemiplimab in patients (pts) with advanced malignancies
Presenter: Michael Migden
Session: Poster Display session 3
Resources:
Abstract
2120 - A burst of highly differentiated CD4 TL identifies a subset of fast progressors, and correlates with hyperprogressive disease in NSCLC patients treated with ICI
Presenter: Hugo Arasanz
Session: Poster Display session 3
Resources:
Abstract
4254 - Nivolumab treatment in advanced non-small cell lung cancer (aNSCLC): a French nationwide retrospective cohort (UNIVOC Study)
Presenter: Christos Chouaid
Session: Poster Display session 3
Resources:
Abstract