Abstract 3629
Background
Programmed death-1 inhibitors (PD-1i) have been approved in the treatment of patients (pts) with recurrent/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) who progressed on or after platinum-containing regimens. More recently, it has been shown that pembrolizumab was superior to the standard EXTREME regimen in first line setting in pts with R/M SCCHN with CPS > 20% and 1% in term of overall survival (OS). We aim in this study to compare the efficacy of immune checkpoint inhibitors (ICI) used as first versus second line in R/M SCCHN to define the best treatment strategy.
Methods
A retrospective study was conducted at 4 French university hospitals. Eligibility criteria were pts treated with ICI for R/M SCCHN as first or second line treatment only and for whom efficacy data were available between September 2014 and March 2019. Clinical and radiological data and outcome were collected from review of medical records.
Results
One hundred ninety two pts were included in this study: 57 pts (30%) received ICI as first line treatment (G1) and 135 pts (70%) as second line setting (G2). Median age at the beginning of ICI was 63 years (range 25-86). All pts were in clinical trials. In G1, ICI was given as monotherapy in 23% of pts and in 66% of pts in G2. The objective response rate (ORR) to ICI in G1 was 17.5% and 17.9% in G2 (p = 0.004). The median duration of response to ICI in G1 was 7.3 months compared to 15.2 months in G2 (p = 0.04). The median progression free survival in G1 was 3.3 months versus 2.7 months in G2 (p = 0.7). The mOS from the beginning of ICI was 12.2 months in G1 versus 11.6 months in G2 (p = 0.7). The mOS from the diagnosis of advanced disease was 15.9 months in G1 versus 22.1 months in G2 (p = 0.11) after a median follow-up of 28.5 months. In G1 38 pts (67%) and 73 pts (53%) in G2 received salvage chemotherapy (SCT) after progression on ICI. The ORR to SCT was 44% in G1 and 34% in G2.
Conclusions
ICI given as second line treatment were associated with similar OS but significant prolonged duration of response. We showed a trend to better OS in the cohort of pts who received ICI in second line setting (22 months).
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.
Resources from the same session
4021 - Prospective pathological experience with research biopsies in the context of clinical trials at Vall d’Hebron Institute of Oncology
Presenter: Paolo Nuciforo
Session: Poster Display session 3
Resources:
Abstract
5603 - Development of a comprehensive next-generation targeted sequencing assay for detection of gene-fusions in solid tumors
Presenter: Vinay Mittal
Session: Poster Display session 3
Resources:
Abstract
4952 - Next-generation sequencing for better treatment strategy of cancer of unknown primary (CUP)
Presenter: Kang Kook Lee
Session: Poster Display session 3
Resources:
Abstract
4590 - Circulating-free DNA analysis from long-term surviving metastatic colorectal cancer patients undergoing surgery for resectable disease.
Presenter: Michele Ghidini
Session: Poster Display session 3
Resources:
Abstract
3696 - Ultra-sensitive detection of circulating tumor DNA identifies patients in high risk of recurrence in early stages melanoma
Presenter: Filip Janku
Session: Poster Display session 3
Resources:
Abstract
4295 - Identification of the founder BRCA1 mutation c.4117G>T (p.Glu1373*) recurring in Abruzzo and Lazio regions of Central Italy and predisposing to breast/ovarian and BRCA1-related cancers
Presenter: Daniela Di Giacomo
Session: Poster Display session 3
Resources:
Abstract
2214 - Enzalutamide (ENZA) and Apalutamide (APA) In vitro chemical reactivity studies and Activity in a Mouse Drug Allergy Model (MDAM)
Presenter: Mausumee Guha
Session: Poster Display session 3
Resources:
Abstract
5044 - Influence of genetic variation in COMT on cisplatin-induced nephrotoxicity in cancer patients.
Presenter: Bram Agema
Session: Poster Display session 3
Resources:
Abstract
3293 - Cardioprotective and anti-inflammatory effects of Empagliflozin during treatment with Doxorubicin: a cellular and preclinical study
Presenter: Vincenzo Quagliariello
Session: Poster Display session 3
Resources:
Abstract
3324 - Breast Cancer Organoids Model Treatment Response of HER2 Targeted Therapy in HER2-mutant Breast Cancer
Presenter: Xuelu Li
Session: Poster Display session 3
Resources:
Abstract