Abstract 922P
Background
Immune checkpoint inhibitors (CPI) are the standard of care in patients (pts) failing platinum-based therapy for recurrent or metastatic head and neck cancer (r/m SCCHN). Here we explored the overall clinical impact of CPI in two real-world patient cohorts.
Methods
Pts with r/m SCCHN treated with CPI monotherapy (CPI-cohort) at the West German Cancer Center (WTZ) were retrospectively evaluated. Results were compared to a historic cohort (HC) treated with cetuximab/platinum-based first line before the approval of CPI. Clinico-pathological parameters, treatment trajectories and outcomes were retrieved from the electronic health record. Kaplan–Meier method, log rank test and Cox proportional-hazard model with Hazard ratios (HR) and 95% confidence intervals (95% CI) were applied. The study was approved by the institutional ethics committee.
Results
The CPI-cohort (CC) included 68 pts which was compared to the HC of 201 pts. Baseline clinical characteristics for CC vs HC: median age 60.9 vs 61.8y; 20.5 vs 16.5% of pts ≥70y and 38.6 vs 32.5% of pts with an ECOG PS of ≥2. Median overall survival (mOS) of the CPI-cohort was 16.77m (95% CI 11.31-22.23, N = 68) vs 10.81 (95% CI 9.02-12.60, N = 201; P < 0.001) for pts in HC, which did not receive a CPI. For pts in HC receiving second- or further line therapy the mOS was 12.35 (95% CI 9.11-15.59, N = 99; P = 0.004). Pts achieving disease control (CR/PR/SD; 51.9%) upon CPI had an improved mOS of 27.75 vs 3.45m for pts progressive upon CPI (P < 0.001). No survival benefit for pts with CR/PR vs SD was detected (P = 0.64). The response to CPI was an independent prognostic factor (P < 0.005) in multivariate regression analyses including age, ECOG, primary tumor side and whether CPI was given in first or further line. Within the subgroup of pts receiving at least one additional line of therapy after progression on CPI a trend for superiority of taxan-based regimen was displayed (n.r. vs 8.15m, P = 0.073).
Conclusions
CPI monotherapy is effective in an unselected real-world r/m SCCHN pts population. The response to CPI is an independent positive predictor for long-term survival. Taxan-based treatment appears to be the most promising strategy after failure of CPI and platinum.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
M. Pogorzelski: Financial Interests, Personal and Institutional, Invited Speaker: Boehringer Ingelheim; Financial Interests, Personal and Institutional, Advisory Board: Boehringer Ingelheim; Financial Interests, Personal and Institutional, Invited Speaker: Bristol Myers-Squibb; Financial Interests, Personal and Institutional, Advisory Board: Merck Healthcare KGaA; Financial Interests, Personal and Institutional, Invited Speaker: Merck Sharp & Dohme. T. Gauler: Financial Interests, Personal and Institutional, Invited Speaker: AstraZeneca; Financial Interests, Personal and Institutional, Invited Speaker: Bristol Myers-Squibb; Financial Interests, Personal and Institutional, Invited Speaker: Merck Healthcare KGaA; Financial Interests, Personal and Institutional, Invited Speaker: Merck Sharp & Dohme; Financial Interests, Personal and Institutional, Invited Speaker: Roche. V. Grünwald: Financial Interests, Personal and Institutional, Invited Speaker: AstraZeneca; Financial Interests, Personal and Institutional, Invited Speaker: Bristol Myers-Squibb; Financial Interests, Personal and Institutional, Invited Speaker: Ipsen; Financial Interests, Personal and Institutional, Invited Speaker: Pfizer; Financial Interests, Personal and Institutional, Research Grant: Novartis; Financial Interests, Personal, Invited Speaker: Eisai; Financial Interests, Personal, Invited Speaker: EUSAPharm; Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Invited Speaker: Janssen-Cilag; Financial Interests, Personal, Invited Speaker: Merck Serono; Financial Interests, Personal, Invited Speaker: MSD; Financial Interests, Personal, Invited Speaker: Lilly; Financial Interests, Personal, Invited Speaker: PharmaMar; Financial Interests, Personal, Invited Speaker: Asklepios Clinic; Financial Interests, Personal, Invited Speaker: Clinic of Oldenburg; Financial Interests, Personal, Invited Speaker: Diakonie Clinic; Financial Interests, Personal, Invited Speaker: Dortmund Hospital; Financial Interests, Personal, Invited Speaker: Onkowissen. M. Schuler: Financial Interests, Personal and Institutional, Advisory Role: AstraZeneca; Financial Interests, Personal and Institutional, Advisory Role: Boehringer Ingelheim; Financial Interests, Personal and Institutional, Advisory Role: Bristol-Meyers Squibb; Financial Interests, Personal and Institutional, Advisory Role: Celgene; Financial Interests, Personal and Institutional, Advisory Role: Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG); Financial Interests, Personal and Institutional, Advisory Role: Lilly; Financial Interests, Personal and Institutional, Advisory Role: Novartis; Financial Interests, Personal and Institutional, Invited Speaker: Alexion; Financial Interests, Personal and Institutional, Invited Speaker: Boehringer Ingelheim; Financial Interests, Personal and Institutional, Invited Speaker: Celgene; Financial Interests, Personal and Institutional, Invited Speaker: GlaxoSmithKline; Financial Interests, Personal and Institutional, Invited Speaker: Lilly; Financial Interests, Personal and Institutional, Invited Speaker: Novartis; Financial Interests, Institutional, Funding: Boehringer Ingelheim; Financial Interests, Institutional, Funding: Bristol-Meyers Squibb; Financial Interests, Institutional, Funding: Novartis; Financial Interests, Personal and Institutional, Other, Patents: University Duisburg-Essen. S. Kasper: Financial Interests, Personal and Institutional, Invited Speaker: Roche; Financial Interests, Personal and Institutional, Invited Speaker: Bristol-Myers Squibb; Financial Interests, Personal and Institutional, Invited Speaker: Merck Sharp & Dohme; Financial Interests, Personal and Institutional, Invited Speaker: Amgen; Financial Interests, Personal and Institutional, Invited Speaker: Merck Serono; Financial Interests, Personal and Institutional, Invited Speaker: Sanofi Aventis; Financial Interests, Personal and Institutional, Invited Speaker: AstraZeneca; Financial Interests, Personal and Institutional, Invited Speaker: Janssen Pharmaceuticals; Financial Interests, Personal and Institutional, Invited Speaker: Celgene; Financial Interests, Personal and Institutional, Invited Speaker: Lilly; Financial Interests, Personal and Institutional, Invited Speaker: Servier. All other authors have declared no conflicts of interest.