Impact of salvage chemotherapy after immune checkpoint inhibitor for recurrent or metastatic head and neck cancer

• Published in: Head & neck 2024-08, Vol.46 (8), p.1855-1864
• Main Authors: Matoba, Takuma, Minohara, Kiyoshi, Kawakita, Daisuke, Sawabe, Michi, Takano, Gaku, Oguri, Keisuke, Murashima, Akihiro, Iwaki, Sho, Tsuge, Hiroshi, Imaizumi, Sae, Hojo, Wataru, Kondo, Ayano, Tsukamoto, Koji, Iwasaki, Shinichi
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cetuximab - therapeutic use; Chemotherapy; Female; Head & neck cancer; Head and neck; head and neck cancer; Head and Neck Neoplasms - drug therapy; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - therapy; Humans; immune checkpoint inhibitor; Immune checkpoint inhibitors; Immune Checkpoint Inhibitors - therapeutic use; immune‐related adverse effects; Male; Metastases; Middle Aged; Neoplasm Recurrence, Local - drug therapy; Paclitaxel; Paclitaxel - administration & dosage; Paclitaxel - therapeutic use; paclitaxel monotherapy; Progression-Free Survival; Retrospective Studies; salvage chemotherapy; Salvage Therapy; Survival
• ISSN: 1043-3074; 1097-0347; 1097-0347
• DOI: 10.1002/hed.27643

Background It is unclear witch regimen is optimal as salvage chemotherapy (SCT) after immune checkpoint inhibitor (ICI) monotherapy for recurrent or metastatic head and neck cancer (RM‐HNC). Methods This study enrolled 109 patients. Overall survival (OS) and progression‐free survival 2 (PFS2) were compared between patients stratified by SCT regimen. Results Of the 109 patients, 55 underwent SCT after the failure of ICI monotherapy. The OS of these 55 patients was longer than that of patients who did not undergo SCT. The OS and PFS2 were similar between patients treated with paclitaxel (PTX) and cetuximab (Cmab) combination and those treated with PTX monotherapy. The occurrence of irAEs did not impact PFS2 nor OS. Conclusions SCT can improve the survival outcomes of patients with RM‐HNC. In addition to PTX and Cmab, PTX monotherapy is also considered an effective SCT regimen. SCT is effective regardless of the presence or absence of irAEs.