886P - Retrospective multicentric survival analysis of patients receiving TPEx regimen (docetaxel, platinum and cetuximab) as first line treatment of recurrent or metastatic squamous cell carcinoma of the head and neck

Background

TPEx regimen is a first line treatment option for recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) if PD-L1 status is negative, or in cases of high tumor burden. We sought to evaluate the survival rates of patients (pts) receiving TPEx as first line treatment for R/M HNSCC, particularly since the advent of immunotherapy (IO) as second line therapy.

Methods

This multicentric retrospective study included pts who received between 2018 and June 2023 at least the first day of a first cycle of TPEx (docetaxel 75 mg/m2; cisplatin 75 or carboplatin AUC5; cetuximab 400 induction/250 weekly), with a performance status of 0 or 1. The primary endpoint was overall survival (OS), i.e, the time from start of treatment to death from any cause. Secondary end-points were: progression free survival under TPEx (PFS1), rate of patients exposed to IO after TPEx, PFS of pts receiving IO after TPEx (PFS2), OS and PFS according to CPS (<1 or ≥ 1) when available.

Results

204 pts were included, mainly men (86%), previously treated for localized HNSCC (78%) and relapsing beyond 6 months after the end of localized treatment (69%). 32% of pts had clinically threatening disease and 7% had liver metastases. CPS was available for 88 pts (43%). Pts were treated with a median of 4 cycles of TPEx, followed by cetuximab maintenance for 154 pts (75%). Overall, 148 pts (73%) were exposed to IO after TPEx, either as a second line treatment (68%) or third line or more (5%). After a median follow-up of 35.8 months, median OS was 17.9 months. Median PFS1 was 6.0 months. Median PFS2 on IO was 2.3 months, and median time from progression on IO to death was 5.7 months (IQR 2.2-10.8). In multivariate analysis, clinically threatening disease and the use of carboplatin instead of cisplatin remained significantly associated with OS (HR 1.9 CI 1.2-2.8; HR 1.5 CI 1.0-2.1, respectively). When CPS was available, a multivariate analysis did not kept CPS as significantly associated with OS.

Conclusions

The median OS of 17.9 months in this multicentric cohort under TPEx as first line treatment for R/M HNSCC compares favorably with historical data. Most pts (73%) were exposed to IO after TPEx.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

C. Abdeddaim: Financial Interests, Personal, Advisory Board: GSK, AstraZeneca, Merck; Financial Interests, Institutional, Invited Speaker: AstraZeneca, MSD; Financial Interests, Institutional, Advisory Board: MSD; Financial Interests, Institutional, Local PI: GSK, Debio Pharm, MSD, Zentalis; Financial Interests, Institutional, Coordinating PI: Epizyme. C. Even: Financial Interests, Personal, Advisory Board: BMS, MSD, Innate Pharma, Merck Serono; Financial Interests, Institutional, Advisory Board: F Star Therapeutics, Novartis, Elevar, Bicara, PDS Biotechnology, GSK, Merus; Financial Interests, Institutional, Local PI: BMS, AstraZeneca, ISA pharmaceutics, MSD, Debiopharma, Ayala, Gilead, GSK, Beigene, Takeda, Genmab, Seagen, Nykode; Financial Interests, Institutional, Coordinating PI: BMS, Novartis, Sanofi. All other authors have declared no conflicts of interest.