The impact of locoregional treatment on response to nivolumab in advanced platinum refractory head and neck cancer: The need trial in Journal of Clinical Oncology
2020
AO Cuneo
Tipo pubblicazione
Conference Abstract
Autori/Collaboratori (17)Vedi tutti...
Marchetti P
IRCCS Ospedale Policlinico San Martino, Genoa, Italy
Nuti M
IRCCS Ospedale Policlinico San Martino, Genoa, Italy
Merlano MC
IRCCS Ospedale Policlinico San Martino, Genoa, Italy
et alii...
Abstract
Background: Immunotherapy is the standard of care in the treatment of platinum-refractory recurrent/metastatic head and neck squamous cell carcinoma (R/M-HNSCC). Previous loco-regional treatment could have an impact on the immune system and response to Nivolumab. The aim of this study is to evaluate the efficacy and safety of Nivolumab in a real world population, identifying the impact of the clinic-pathological characteristics and previous treatment in prediction of early progression. Methods: This is a observational, multicenter retrospective/prospective study including patients (pts) with platinum refractory R/M HNSCC who received Nivolumab 240 mg every 2 weeks until disease progression or unacceptable toxicity, from October 2018 to October 2019. We analyzed treatment outcomes in term of early progression (within 3 months), clinical benefit, progression free survival (PFS) and overall survival (OS). To determine the influence on outcomes, the following variables were investigated: primary tumor sub-site, age, gender, ECOG, previous loco-regional treatment, previous systemic therapy, metastatic site. Results: Data from 61 pts were reviewed: 15 oral cavity, 14 oropharynx, 7 hyphofarynx, 19 larynx, 6 paranasal sinus. Median age was 66 years (29-82), 48 pts were men. Forty-nine pts (80%) had performance status (ECOG) ? 1 at baseline evaluation. Eleven pts (18%) had only loco-regional recurrence, while 50 pts (82%) had one or more metastatic site. 32 (52%) and 17 pts (28%) had smoking and alcohol abuse history, respectively. 44 pts (72%) received surgery followed by adjuvant radiant treatment at standard dose (28, 46%) or concomitant definitive radiotherapy (16, 26%) as upfront treatment with curative intent. With a median follow up of 4 months (range 1-11), early progression occurred in 39 pts during Nivolumab treatment (64%), while clinical benefit (stable disease and partial response) was achieved in 22 pts (36%). No G3-G4 toxicities occurred. Early progre
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DOI : 10.1200/JCO.2020.38.15-suppl.e18508
Keywords
prospective study; progression free survival; prediction; primary tumor; pharmacokinetics; paranasal sinus; overall survival; oropharynx; neck dissection; multicenter study; mouth cavity; male; lymphatic system; major clinical study; larynx; human; immune response; head and neck squamous cell carcinoma; gender; follow up; female; drug therapy; drug safety; drug megadose; controlled study; conference abstract; comparative effectiveness; radiotherapy; clinical trial; cancer survival; cancer surgery; cancer recurrence; cancer patient; alcohol abuse; aged; advanced cancer; platinum; nivolumab; adjuvant; retrospective study; smoking; surgery; systemic therapy;