复发性或转移性头颈部鳞状细胞癌患者进展期后的西妥昔单抗治疗:一项基于全国人群的研究(THNS-2021-08)。

IF 4.4 3区 医学 Q2 ONCOLOGY Targeted Oncology Pub Date : 2024-01-01 Epub Date: 2024-01-29 DOI:10.1007/s11523-023-01028-7
Hung-Ming Wang, Pei-Jen Lou, Muh-Hwa Yang, Tein-Hua Chen, Ming-Yu Lien, Jin-Ching Lin, Jo-Pai Chen, Wei-Chen Lu, Hsueh-Ju Lu, Tai-Lin Huang, Chia-Jui Yen, Shang-Yin Wu, Hui-Ching Wang, Meng-Che Hsieh
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引用次数: 0

摘要

背景:人们对西妥昔单抗治疗进展期后(TBP)与复发性或转移性头颈部鳞状细胞癌(R/M HNSCC)患者生存期的关系知之甚少。尽管免疫检查点抑制剂(ICIs)目前已被视为一线治疗药物,但并非所有患者都适合使用ICIs:我们开展了一项多中心回顾性研究,以评估西妥昔单抗TBP在含西妥昔单抗一线化疗失败后的R/M HNSCC患者中的作用:我们的研究纳入了一线西妥昔单抗化疗后肿瘤进展的R/M HNSCC患者。研究估算了肿瘤学结果,包括西妥昔单抗治疗终止时间(TTD)、无进展生存期2(PFS2)、总生存期(OS)、总反应率(ORR)和疾病控制率(DCR)。对生存率进行了多变量考克斯回归分析。结果:共有498名患者符合条件:共有498名患者符合条件,其中TBP组259人,非TBP组239人。两组患者最常用的一线化疗方案均为EXTREME方案。至于二线治疗,TBP 组最常用的方案是 TPEx,非 TBP 组最常用的方案是基于类固醇的化疗。TBP组的中位TTD为8.7个月,非TBP组为5.5个月(P<0.001)。在生存期方面,TBP 组的中位 OS1 明显长于非 TBP 组[14.1 个月对 10.9 个月 (p = 0.016)]。多变量分析表明,西妥昔单抗TBP是与OS独立相关的因素:我们的回顾性研究表明,西妥昔单抗TBP对一线西妥昔单抗化疗失败后的R/M HNSCC患者有效,并能提高患者的生存率。有必要进一步开展前瞻性研究,以验证西妥昔单抗TBP在R/M HNSCC中的作用。
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Cetuximab Treatment beyond Progression in Patients with Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: A Nationwide Population-Based Study (THNS-2021-08).

Background: Little is known regarding the association of cetuximab treatment beyond progression (TBP) with survival among patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). Although immune checkpoint inhibitors (ICIs) are now considered as first-line treatment, not all patients are suitable for ICIs.

Objective: We conducted a multicenter, retrospective study to evaluate the role of cetuximab TBP in patients with R/M HNSCC after failure of first-line cetuximab-containing chemotherapy.

Patients and methods: Patients with R/M HNSCC who had tumor progression after first-line cetuximab-containing chemotherapy were included into our study. Oncologic outcomes were estimated including time to cetuximab treatment discontinuation (TTD), progression-free survival 2 (PFS2), overall survival (OS), overall response rate (ORR), and disease control rate (DCR). Multivariate cox regression analysis with survival were conducted. Subgroup analysis with P16 and programmed death ligand 1 expression were performed.

Results: A total of 498 patients were eligible with 259 patients in the TBP group and 239 patients in the non-TBP group. The most common first-line chemotherapy was the EXTREME regimen in both groups. As for second-line treatment, the most common regimen were TPEx in the TBP group and taxane-based chemotherapy in the non-TBP group. Median TTD was 8.7 months in TBP and 5.5 months in non-TBP (p < 0.001). In terms of survival, median OS1 was significant longer in the TBP group than in the non-TBP group [14.1 months versus 10.9 months (p = 0.016)]. Multivariate analysis demonstrated cetuximab TBP was a factor independently associated with OS.

Conclusions: Our retrospective study suggests cetuximab TBP to be effective and to provide better survival for patients with R/M HNSCC after failure of first-line cetuximab-containing chemotherapy. Further prospective studies are warranted to validate the role of cetuximab TBP in R/M HNSCC.

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来源期刊
Targeted Oncology
Targeted Oncology 医学-肿瘤学
CiteScore
8.40
自引率
3.70%
发文量
64
审稿时长
>12 weeks
期刊介绍: Targeted Oncology addresses physicians and scientists committed to oncology and cancer research by providing a programme of articles on molecularly targeted pharmacotherapy in oncology. The journal includes: Original Research Articles on all aspects of molecularly targeted agents for the treatment of cancer, including immune checkpoint inhibitors and related approaches. Comprehensive narrative Review Articles and shorter Leading Articles discussing relevant clinically established as well as emerging agents and pathways. Current Opinion articles that place interesting areas in perspective. Therapy in Practice articles that provide a guide to the optimum management of a condition and highlight practical, clinically relevant considerations and recommendations. Systematic Reviews that use explicit, systematic methods as outlined by the PRISMA statement. Adis Drug Reviews of the properties and place in therapy of both newer and established targeted drugs in oncology.
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