Abstract 926P
Background
Immune checkpoint inhibitors (ICIs) have been shown to improve treatment efficacy in patients with recurrent and/or metastatic head and neck squamous cell carcinoma (RM HNSCC). We assessed the clinical outcomes, treatment patterns, and prognostic factors in real-word practice after ICI therapies for RM HNSCC patients receiving first-line cetuximab plus chemotherapy.
Methods
This retrospective observational study was conducted at two tertiary medical centres in Taiwan. Patients with RM HNSCC who received cetuximab plus chemotherapy as first-line therapy were included between January 2017 and July 2019. The study endpoints were response rates, progression-free survival (PFS), and overall survival (OS). Univariable and multivariable analyses of prognostic factors were estimated using the Cox proportional hazards model.
Results
We identified 290 patients treated with first-line cetuximab and chemotherapy. Median OS was 9.1 months (95% confidence interval [CI] 8.2 to 10.4), whereas the median PFS was 5.0 months (95% CI 4.3 to 5.7). In patients with platinum resistance, the median OS was 10.4 months (95% CI 8.1-13.3) with ICIs versus 6.3 months (95% CI 5.1-7.6) without ICIs (P<0.01). In patients with platinum-sensitivity, the median OS was 20.6 months (95% CI 11.3-22.6) with ICIs versus 9.1 months without ICs (95% CI, 7.9-10.9)(P<0.01); OS benefit with ICIs was similar in patients who received ICIs after progression on cetuximab and patients who received cetuximab in combination with ICIs. On multivariable analysis, independent favourable prognostic factors for OS were platinum-sensitivity, better objective response to cetuximab and ICIs.
Conclusions
ICIs appeared to improve OS, even in platinum-resistant populations, which supports the use of these agents in patients with RM HNSCC who were treated with cetuximab plus chemotherapy as first-line therapy. The reduction in risk of death with ICIs was similar for the combination or sequencing of cetuximab.
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.