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Impact of previous nivolumab treatment on the response to taxanes in patients with recurrent/metastatic head and neck squamous cell carcinoma. | LitMetric

AI Article Synopsis

  • Immune checkpoint inhibitors, like nivolumab, are commonly used for treating recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC), and this study explores how taxane treatment responds after patients progress on nivolumab.
  • In a study with 185 patients (71 after nivolumab treatment and 114 without), the objective response rate (ORR) was significantly better in the post-nivolumab group, suggesting they responded well to subsequent taxane therapy.
  • Although overall survival and progression-free survival were similar between both groups, the post-nivolumab patients had a notably improved PFS ratio, indicating taxanes could be an effective third-line treatment after nivolumab.

Article Abstract

Background: Immune checkpoint inhibitors are widely used in recurrent and/or metastatic head and neck squamous cell carcinoma (R/M HNSCC). We aimed to describe response rates to taxanes after progression on nivolumab in R/M HNSCC patients.

Methods: In this multicentric retrospective comparative study, we included patients treated with taxane monotherapy from 2014 to 2020. Patients were divided into two groups depending on whether they received nivolumab before taxanes (post-nivolumab group) or not (control group). The primary end-point was objective response rate (ORR) comparison between the two groups. The secondary end-points included disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and PFS ratio (PFSr=PFS associated with taxanes divided by PFS associated with the previous line of treatment), a survival marker used for comparison of different treatment lines.

Results: Between July 2014 and August 2020, 185 patients were included (114 in the control group and 71 in the post-nivolumab group). ORR was significantly higher in the post-nivolumab group (39.4% versus 26.3%, p = 0.03) as was DCR (69% versus 50%, P = 0.06). The median OS (7.5 months) and PFS (3.5 months) were not significantly different in the two groups, whereas PFSr was significantly improved in the post-nivolumab group (1.63 versus 1.11, P = 0.004).

Conclusion: Response and DCRs with taxanes are improved after prior exposure to nivolumab. Thus, taxane monotherapy could be a good choice as third-line therapy after nivolumab following a platinum-based first line. These results currently apply to patients without access to or potential benefit from first-line pembrolizumab.

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Source
http://dx.doi.org/10.1016/j.ejca.2021.09.025DOI Listing

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