2026-04-13T13:45:08Zhttps://recercat.cat/oai/request

oai:recercat.cat:2445/2199902026-03-20T08:15:53Zcom_2072_1057col_2072_478916col_2072_478917

Salvage chemotherapy after progression on immunotherapy in recurrent/metastatic squamous cell head and neck carcinoma Llop, Sandra Plana, Maria Tous, Sara Ferrando Díez, Angelica Brenes, Jesús Juarez, Marc Vidales Sepúlveda, Zara Vilajosana, Esther Linares, Isabel Arribas, Lorena Duch, Maria Fulla, Marta Brunet, Aina Lozano, Alicia Cirauqui, Beatriz Mesía, Ricard Oliva, Marc Quimioteràpia Immunoteràpia Càncer de pell Coll Cap Chemotherapy Immunotheraphy Skin cancer Neck Head 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. 2025-03-25T12:48:01Z 2025-03-25T12:48:01Z 2024-11-25 2025-01-22T15:32:28Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion 2234-943X https://hdl.handle.net/2445/219990 39655068 eng Reproducció del document publicat a: https://doi.org/10.3389/fonc.2024.1458479 Frontiers in Oncology, 2024, vol. 14 https://doi.org/10.3389/fonc.2024.1458479 cc-by (c) Llop, Sandra et al., 2024 http://creativecommons.org/licenses/by/3.0/es/ info:eu-repo/semantics/openAccess 9 p. application/pdf Frontiers Media SA Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))