Weekly chemotherapy as first line treatment in frail head and neck cancer patients in the immunotherapy era.

Autor: Botticelli A; Department of Clinical and Molecular Oncology, 'Sapienza' University of Rome, 00185, Rome, Italy., Pomati G; Department of Molecular Medicine, 'Sapienza' University of Rome, 00185, Rome, Italy., Cirillo A; Department of Radiological, Oncological and Anatomo-Pathological Science, 'Sapienza' University of Rome, Viale Regina Elena 324, 00185, Rome, Italy. alessio.cirillo@uniroma1.it., Mammone G; Department of Radiological, Oncological and Anatomo-Pathological Science, 'Sapienza' University of Rome, Viale Regina Elena 324, 00185, Rome, Italy., Ciurluini F; Department of Radiological, Oncological and Anatomo-Pathological Science, 'Sapienza' University of Rome, Viale Regina Elena 324, 00185, Rome, Italy., Cerbelli B; Department of Radiological, Oncological and Anatomo-Pathological Science, 'Sapienza' University of Rome, Viale Regina Elena 324, 00185, Rome, Italy., Sciattella P; Department of Statistical Sciences, Sapienza University of Rome, 00161, Rome, Italy., Ralli M; Odontostomatological and Maxillo-Facial Science, 'Sapienza' University of Rome, 00185, Rome, Italy., Romeo U; Odontostomatological and Maxillo-Facial Science, 'Sapienza' University of Rome, 00185, Rome, Italy., De Felice F; Department of Radiological, Oncological and Anatomo-Pathological Science, 'Sapienza' University of Rome, Viale Regina Elena 324, 00185, Rome, Italy., Catalano C; Department of Radiological, Oncological and Anatomo-Pathological Science, 'Sapienza' University of Rome, Viale Regina Elena 324, 00185, Rome, Italy., Vullo F; Department of Radiological, Oncological and Anatomo-Pathological Science, 'Sapienza' University of Rome, Viale Regina Elena 324, 00185, Rome, Italy., Della Monaca M; Odontostomatological and Maxillo-Facial Science, 'Sapienza' University of Rome, 00185, Rome, Italy., Amirhassankhani S; MSc Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge Rd, Bishop's, London, SE1 7EH, UK., Tomao S; Department of Radiological, Oncological and Anatomo-Pathological Science, 'Sapienza' University of Rome, Viale Regina Elena 324, 00185, Rome, Italy., Valentini V; Odontostomatological and Maxillo-Facial Science, 'Sapienza' University of Rome, 00185, Rome, Italy., De Vincentiis M; Odontostomatological and Maxillo-Facial Science, 'Sapienza' University of Rome, 00185, Rome, Italy., Tombolini V; Department of Radiological, Oncological and Anatomo-Pathological Science, 'Sapienza' University of Rome, Viale Regina Elena 324, 00185, Rome, Italy., Della Rocca C; Department of Medico-Surgical Sciences and Biotechnology, Sapienza University, Polo Pontino, 00185, Rome, Italy., Polimeni A; Odontostomatological and Maxillo-Facial Science, 'Sapienza' University of Rome, 00185, Rome, Italy., di Gioia C; Department of Radiological, Oncological and Anatomo-Pathological Science, 'Sapienza' University of Rome, Viale Regina Elena 324, 00185, Rome, Italy., Corsi A; Department of Radiological, Oncological and Anatomo-Pathological Science, 'Sapienza' University of Rome, Viale Regina Elena 324, 00185, Rome, Italy., D'Amati G; Department of Radiological, Oncological and Anatomo-Pathological Science, 'Sapienza' University of Rome, Viale Regina Elena 324, 00185, Rome, Italy., Mezi S; Department of Radiological, Oncological and Anatomo-Pathological Science, 'Sapienza' University of Rome, Viale Regina Elena 324, 00185, Rome, Italy., Marchetti P; Department of Clinical and Molecular Oncology, 'Sapienza' University of Rome, 00185, Rome, Italy.
Jazyk: angličtina
Zdroj: Journal of translational medicine [J Transl Med] 2021 Jul 12; Vol. 19 (1), pp. 303. Date of Electronic Publication: 2021 Jul 12.
DOI: 10.1186/s12967-021-02975-3
Abstrakt: Objective: First-line therapy for metastatic squamous cell carcinoma of the head and neck (R/M HNSCC) has been revolutionized by the introduction of anti-checkpoint monoclonal antibodies, which have shown a significant improvement in overall survival (OS) gaining approval in a first line setting. Efficacy and safety of first-line weekly chemotherapy, compared to 3-weeks treatment, was retrospectively evaluated in a frail patient population with R/M HNSCC with the aim to evaluate its role as part of a personalized first-line approach.
Methods: A total of 124 patients with locally incurable R/M HNSCC receiving weekly (21) or three-weekly (103) chemotherapy plus cetuximab in a first line setting from December 2010 to September 2020 were retrospectively reviewed. Treatment outcomes in terms of objective response rate (ORR), progression-free survival (PFS), overall survival (OS) and toxicities were analysed.
Results: Patients in the three-week subgroup were ECOG PS 0 (39) and 1 (64) while patients in weekly group (21) were all PS 2. No significant differences were reported in terms of age, sex, smoking and previous alcohol abuse considering the two distinct subgroups. Moreover, no statistically significant difference was found in PFS and OS between the two treatment subgroups. The response rate was 35% (36 patients) and 34% (7 patients) in three-week and weekly treatment group, respectively. Seventy patients (68%) in the three-week group experienced chemotherapy-related toxicities, predominantly G3. In the weekly group a predominantly low-grade toxicity was found in a lower number of patients (52%).
Conclusion: The weekly schedule appears to be an active and safe strategy in frail patients with R/M HNSCC. Based on these data, a weekly schedule could be considered as a first line treatment in all frail patients excluded from pembrolizumab treatment and a study on the combination of weekly chemotherapy and immunotherapy should be performed.
(© 2021. The Author(s).)
Databáze: MEDLINE
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