Response rates and survival to systemic therapy after immune checkpoint inhibitor failure in recurrent/metastatic head and neck squamous cell carcinoma. (February 2020)

• Record Type: Journal Article
• Authors: Pestana, Roberto Carmagnani; Becnel, Melody; Rubin, Maria Laura; Torman, Danice K; Crespo, James; Phan, Jack; Hanna, Ehab; Bell, Diana; Glisson, Bonnie S; Johnson, Jason M.; Lee, J. Jack; Ferrarotto, Renata
• Is Part Of: Oral oncology. Volume 101(2020)
• Publication Date: 2020-02
• Subjects: Head and neck squamous cell carcinoma -- HNSCC -- Immunotherapy -- Immune checkpoint inhibitors; CR complete response -- EGFR epidermal growth factor receptor -- HNSCC head and neck squamous cell carcinoma -- ICI immune checkpoint inhibitor -- ORR overall response rates -- OS overall survival -- PD-1 programmed-death receptor 1 -- PFS progression-free survival -- PR partial response; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2019.104523
• Languages: English
• ISSNs: 1368-8375

Abstract

Highlights: In head and neck cancer, response rate to systemic therapy after anti-PD1 was 42%. The median overall survival to systemic therapy after anti-PD1 was 8.4 months. The activity compares favorably to historical controls of second-line therapy. Studies on the optimal sequencing of chemotherapy, EGFR, and PD1 inhibitors are needed. Abstract: Objectives: Prior reports have demonstrated a potential enhancement in overall response rate (ORR) to chemotherapy after exposure to immunotherapy. The goal of this study was to evaluate the ORR and survival to chemotherapy and/or targeted therapy in head and neck squamous cell carcinoma (HNSCC) patients who progressed on immune checkpoint inhibitors (ICI). Materials and Methods: We retrospectively collected clinical and pathologic data from patients with recurrent/metastatic HNSCC who progressed on ICI and subsequently received chemotherapy or targeted therapy. ORR was assessed by RECIST version 1.1. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Results: A total of 43 patients met criteria for inclusion. The majority were male (91%) and former smokers (60%). Most patients received ICI as first-line (58.14%); the vast majority was platinum exposed (90.7%). The ORR to ICI was 21%. The ORR to systemic therapy before ICI was 47%, and the ORR after ICI failure was 42%. After progression on ICI, the median PFS and OS on the subsequent line of therapy were 4.2 and 8.4 months respectively. Conclusion: In our cohort of recurrent/metastatic HNSCC patients, the ORR and OS to systemic therapy after progression on ICI were higher than historical controls for second-line or beyond. Further investigations are warranted to better characterize optimal sequencing and combination strategies.