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2024-11-25

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cc-by (c) Llop, Sandra et al., 2024
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/219990

Salvage chemotherapy after progression on immunotherapy in recurrent/metastatic squamous cell head and neck carcinoma

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https://doi.org/10.3389/fonc.2024.1458479

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Objectives Anti-PD-(L)1 agents changed the landscape of recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) treatment. Previous studies showed improved response rates to salvage chemotherapy (SCT) after progression to anti-PD-(L)1 agents. This study aims to evaluate the outcomes of SCT and to identify predictors of response and survival in patients with R/M HNSCC. Materials and methods Retrospective cohort analysis of 63 R/M patients treated with SCT after antiPD-(L1)-based therapy between January 2015 and August 2022. The overall response rate (ORR) was evaluated. Progression-free survival (PFS) and overall survival (OS) were estimated with Kaplan-Meier method. Progression-free survival 2 was calculated from anti-PD-(L)1-therapy start until progression to SCT (PFS2-I). Logistic regression and Cox regression analyses were performed to identify predictors of outcome. Results A total of 63 patients were included: 76% were men, and median age was 60 years. PD-L1 status was available in 68% (61% positive). Up to 71% received SCT as third line or beyond. ORR to SCT was 49% with higher rates in PD-L1 positive tumors, 71% vs. 18% (p=0.001), and cetuximab-containing regimens, 68% vs. 39% (p=0.026). PD-L1 status was the only predictor of ORR in the adjusted model (OR=8.6, 95% CI 1.7-43.0). OS and PFS were 9.3 months (95% CI, 6.5-12.3) and 4.1 months (95% CI, 3.0-5.8) respectively. PFS2-I was 8.6 months (95% CI, 6.6-10.5). In the multivariate analysis, PD-L1 was the only independent factor for OS (HR=0.3; 95% CI, 0.1-0.7), PFS (HR=0.2; 95% CI, 0.1-0.5; p<0.001), and PFS2-I (HR=0.2; 95% CI 0.1-0.5; p<0.001). Conclusion PDL1 status appeared as a strong predictor of response of efficacy for SCT after anti-PD-(L)1 agents. Patients receiving cetuximab-containing regimens trended towards greater benefit. This highlights the importance of treatment sequencing and personalized treatment strategies.

Matèries

Quimioteràpia, Immunoteràpia, Càncer de pell, Coll, Cap

Matèries (anglès)

Chemotherapy, Immunotheraphy, Skin cancer, Neck, Head

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Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Citació

LLOP, Sandra, PLANA, Maria, TOUS, Sara, FERRANDO DÍEZ, Angelica, BRENES, Jesús, JUAREZ, Marc, VIDALES, Zara, VILAJOSANA, Esther, LINARES, Isabel, ARRIBAS, Lorena, DUCH, Maria, FULLA, Marta, BRUNET, Aina, LOZANO, Alicia, CIRAUQUI, Beatriz, MESÍA, Ricard, OLIVA, Marc. Salvage chemotherapy after progression on immunotherapy in recurrent/metastatic squamous cell head and neck carcinoma. _Frontiers in Oncology_. 2024. Vol. 14. [consulta: 20 de gener de 2026]. ISSN: 2234-943X. [Disponible a: https://hdl.handle.net/2445/219990]

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