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
3361 - Providing a nurse-led telephone intervention for patients treated with oral anticancer medication: symptom management and adherence monitoring
Presenter: Etienne Minvielle
Session: Poster Display session 3
Resources:
Abstract
3937 - Chronological evaluation of health-related quality of life and physical symptoms in postoperative pancreatic cancer patients up to 12 months
Presenter: Naoko Sato
Session: Poster Display session 3
Resources:
Abstract
5620 - Understanding the patients’ Experiences of Radiation Therapy: A Qualitative Study on Prostate Cancer Patients
Presenter: Sakarias Johansson
Session: Poster Display session 3
Resources:
Abstract
1792 - Effect of Kegel exercises on prevention of urinary and fecal incontinence in patients with prostate cancer undergoing radiotherapy
Presenter: Aydan Uravylioglu
Session: Poster Display session 3
Resources:
Abstract
2169 - The Meaning of Responsibility – a Secondary Analysis of Patients and Caregivers Calls to an Oncology Emergency Telephone
Presenter: Heidi Jacobsen
Session: Poster Display session 3
Resources:
Abstract
4587 - Cognitive function changes and Associated Factors in Patients Receiving Chemotherapy
Presenter: Elif Dil
Session: Poster Display session 3
Resources:
Abstract
1981 - Prevention of dental complications in patients with multiple myeloma (MM) receiving bisphosphonates treatment
Presenter: CESCA PUIGMARTI
Session: Poster Display session 3
Resources:
Abstract
2725 - Safety profile of oral netupitant/palonosetron in hematopoietic stem cell transplantation recipients.
Presenter: Marina Bosch - Damas
Session: Poster Display session 3
Resources:
Abstract
5112 - Symptomatic and toxicity management of cancer patients using a telephone support model led by the oncology nurse
Presenter: Gemma Simó
Session: Poster Display session 3
Resources:
Abstract
1365 - Symptom cluster of fatigue, sleep disturbance and depression and its impact on quality of life among Chinese breast cancer patients undergoing adjuvant chemotherapy: A cross-sectional study
Presenter: Xiaole HE
Session: Poster Display session 3
Resources:
Abstract