Abstract 899P
Background
Standard of care (SOC) treatment (ttm) of HNSCC patients (pts) was compromised and had to be adapted during the COVID-19 pandemic due to collapse of the healthcare system. The IMPACCT study evaluated the impact of COVID19 on ttm and outcome in pts diagnosed during the first-wave (Guillen, P. ASCO 2021, P6061). The 3-year follow-up results are presented.
Methods
Retrospective cohort analysis of newly diagnosed HNSCC pts from January to June 2020 treated with curative intent (CT20) at Institut Català d’Oncologia (ICO). A cohort treated during the same period at ICO from 2018 and 2019 was used as a control group (CG). Pts were followed until 3 years after diagnosis. Clinical characteristics were obtained from in-house prospective database. Ttm deviations from SOC per COVID-19 contingency protocol (CCP) in CT20 were collected. Recurrence-free survival (RFS) and overall survival (OS) rates from 6 to 36 months (m) were compared among cohorts by Log-rank test.
Results
A total of 306 pts were included: CT20=99; CG=207. Despite balanced disease characteristics, a lower proportion of pts underwent surgery as primary ttm in CT20 vs CG (47 vs 60%, p=0.04). In conservative treated pts, persistence disease rate was higher in CT20 vs CG (25 vs 10% p=0.03). CT20 had significantly lower RFS and OS rates only at 6 and 12m, when compared to CG (see table). Within CT20 pts, 39% had ttm modifications from SOC: 27% due to CCP (surgery to conservative ttm 13%, reduction of high-dose cisplatin to 2 cycles 10%, altered radiotherapy 2%, no induction/adjuvant ttm 2%) and 12% due to COVID-19 (delay of ttm start 9%, upstaging 3%). 3-year RFS nor OS did not differ in pts with ttm modifications vs unmodified ones (57 vs 43% p=0.2; 67 vs 55% p=0.1, respectively).
Table: 899P
6m | 12m | 18m | 24m | 36m | |
RFS (%) | |||||
CG | 88 (83.5-92,7) | 76.0 (70.2-82.3) | 68.2 (62.0-75.1) | 63.0 (56.5-70.2) | 57.3 (50.7-64.7) |
CT20 | 79.8 (71.9-88.6) | 65.2 (56.0-75.9) | 61.8 (52.5-72.8) | 58.4 (49.0-69.6) | 48.6 (39.1-60.4) |
p=0.082 | p=0.055 | p=0.19 | p=0.29 | p=0.13 | |
OS (%) | |||||
CG | 95.8 (93.0-98.7) | 85,3 (80.5-90.5) | 78.5 (72.9-84.6) | 74.9 (69.0-81.3) | 69.6 (63.4-76.5) |
CT20 | 88.9 (82.6-95.6) | 83.3 (76.0-91.4) | 72.2 (63.5-82.1) | 67.7 (58.7-78.1) | 61.6 (52.3-72.7) |
p= 0.025 | p=0.58 | p=0.23 | p=0.20 | p=0.16 |
Conclusions
The COVID-19 pandemic led to ttm modifications from SOC and had an early detrimental impact on RFS and OS when compared to prior years. Ttm modifications did not seem to explain survival differences. Further analyses are ongoing.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
J. Brenes Castro: Financial Interests, Personal, Advisory Role: Merck, Bristol Myers Squibb, Takeda; Financial Interests, Personal, Other, Travel/Accommodation: MSD, Merck, Bristol Myers Squibb, Transgene; Financial Interests, Personal and Institutional, Research Grant: GSK. M. Plana Serrahima: Financial Interests, Personal, Advisory Board: BMS; Financial Interests, Personal, Invited Speaker: MSD; Financial Interests, Institutional, Other: Nanobiotix. M. Oliva: Financial Interests, Personal, Invited Speaker: BMS, Merck, MSD; Financial Interests, Personal, Other, Teaching activities: Merck, MSD; Financial Interests, Personal, Advisory Board: Merck, MSD; Financial Interests, Personal, Writing Engagement: MSD; Financial Interests, Personal, Other, IDMC: Transgene; Non-Financial Interests, Institutional, Local PI: AbbVie, ALX Oncology, Ayala Therapeutics, Bayer, Boehringer Ingelheim, Debiopharm, Gilead, ISA Therapeutics BV, Merck, MSD, Roche, Seagen; Non-Financial Interests, Institutional, Funding: GSK; Non-Financial Interests, Personal and Institutional, Funding: Roche. All other authors have declared no conflicts of interest.
Resources from the same session
868P - A DNA methylation classifier to predict recurrence from clear surgical margins
Presenter: tsima Abou Kors
Session: Poster session 12
869P - Utilizing H&E images and digital pathology to predict response to buparlisib in SCCHN
Presenter: Denis Soulieres
Session: Poster session 12
870P - Dynamic cfHPV DNA changes during induction chemotherapy as an early indicator of treatment responsiveness for locally advanced head and neck cancer patients
Presenter: Yilin Cao
Session: Poster session 12
871P - Detection of circulating tumor DNA in operable loco-regionally advanced HPV-negative head and neck squamous cell carcinoma
Presenter: Ludivine Beaussire
Session: Poster session 12
872P - Prognostic value of pathological intratumor heterogeneity in patients with head and neck squamous cell carcinoma treated with upfront surgery
Presenter: Constance Lamy
Session: Poster session 12
873P - Identification of PIK3CA mutation as a novel predictor of efficacious immunotherapy in head and neck cancer
Presenter: Zongwen Sun
Session: Poster session 12
875P - Proteomic and phosphoproteomic profiling of HNSCC and the role of CDKs as potential drug targets
Presenter: Konrad Klinghammer
Session: Poster session 12
876P - Gene expression analysis in oral potentially malignant disorders (OPMD) with dysplasia identifies patients at high risk of malignant transformation
Presenter: Loris De Cecco
Session: Poster session 12
877P - ROS1 mutations as potential negative predictor for response of immunotherapy in patient with head and neck cancer
Presenter: Yong Yuan
Session: Poster session 12