AI Article Synopsis

  • The study analyzes the effectiveness of local therapies (LT) like surgery and radiotherapy in patients with recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) who have previously undergone treatment with the immune checkpoint inhibitor nivolumab.
  • A retrospective review involved 24 patients, with 37.5% receiving salvage LT and 62.5% undergoing palliative radiotherapy. The outcomes varied significantly based on the type of treatment received, with median overall survival (OS) ranging from 24.5 months to 2.4 months.
  • The findings suggest that for R/M SCCHN patients treated with nivolumab, salvage LT followed by systemic therapy is associated with better survival outcomes,

Article Abstract

Background: In recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN), local therapy (LT) such as surgery or radiotherapy can be treatment options for improved survival or quality of life. To date, however, few reports have addressed the efficacy of LT for sites of disease progression after immune checkpoint inhibitors, including other cancers.

Methods: We conducted a retrospective analysis of patients with R/M SCCHN originating from the oral cavity, oropharynx, hypopharynx, and larynx and treated with nivolumab. We extracted patients undergoing salvage LT or palliative radiotherapy (RT) to the selected progressive lesion at any time after initiation of nivolumab.

Results: Twenty-four patients received LT. Salvage LT was performed in 9 (37.5%) patients, including surgery and definitive RT in 5 and 4 patients, respectively. Palliative RT was performed in 15 (62.5%) patients. LT was provided in 10 (41.7%) patients for oligoprogressive disease. Twelve (50.0%) patients received subsequent systemic therapy immediately after LT. Classification based on patient treatment divided the population into four subgroups with different prognoses (salvage LT followed by subsequent systemic therapy [n = 3], salvage LT alone [n = 6], palliative RT followed by subsequent systemic therapy [n = 9], and palliative RT alone [n = 6]). Median OS in this order was 24.5, 9.0, 7.3, and 2.4 months (p = 0.001). All patients in the salvage LT followed by subsequent systemic therapy group continued nivolumab.

Conclusion: In R/M SCCHN patients who have received nivolumab, salvage LT for the selected progressive lesion with continuation of nivolumab potentially provides an excellent survival prognosis.

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Source
http://dx.doi.org/10.1007/s10147-023-02351-9DOI Listing

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