Roberta Depenni1, Maria Cossu Rocca2, Daris Ferrari3, Giuseppe Azzarello4, Cinzia Baldessari5, Massimiliano Alù6, Franco Nolé7, Carla Codecà8, Giorgia Boscolo9, Marco Piccininni10, Stefano Cavalieri11, Paolo Bossi12. 1. Department of Oncology and Haematology, University Hospital of Modena and Reggio Emilia, Modena, Italy. Electronic address: depenni.roberta@policlinico.mo.it. 2. Department of Medical Oncology, Urogenital and Head and Neck Tumors Medical Treatment European Institute of Oncology, Milano, Italy. Electronic address: maria.cossurocca@ieo.it. 3. Medical Oncology Unit, ASST Santi Paolo e Carlo, Milano, Italy. Electronic address: daris.ferrari@asst-santipaolocarlo.it. 4. Medical Specialties Department, Oncology and Oncologic Hematology, ULSS 3 Serenissima Mirano VE Italy. Electronic address: azzarello.giuseppe@gmail.com. 5. Department of Oncology and Haematology, University Hospital of Modena and Reggio Emilia, Modena, Italy. 6. Medical Oncology Unit, A.R.N.A.S. Ospedali Civico Di Cristina Benfratelli, Palermo, Italy. Electronic address: massimilianoclara2004@gmail.com. 7. Department of Medical Oncology, Urogenital and Head and Neck Tumors Medical Treatment European Institute of Oncology, Milano, Italy. Electronic address: franco.nole@ieo.it. 8. Medical Oncology Unit, ASST Santi Paolo e Carlo, Milano, Italy. Electronic address: carla.codeca@asst-santipaolocarlo.it. 9. Medical Specialties Department, Oncology and Oncologic Hematology, ULSS 3 Serenissima Mirano VE Italy. Electronic address: giorgia.boscolo@aulss3.veneto.it. 10. Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy. Electronic address: marco_piccininni@libero.it. 11. Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. Electronic address: stefano.cavalieri@istitutotumori.mi.it. 12. Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. Electronic address: paolo.bossi@istitutotumori.mi.it.
Abstract
AIM: The aims of the study are to evaluate the clinical outcomes of first-line treatment with platinum-based chemotherapy and cetuximab in patients with relapsing/metastatic head and neck cancer (RM HNC) and to identify predictors of treatment response. METHODS: This is a retrospective, observational, longitudinal, real-world study involving 6 oncology centres in Italy. All consecutive patients with RM HNC treated between January 2007 and December 2016 with a first-line therapy consisting of a platinum-based chemotherapy regimen plus cetuximab were included. The primary objective of the study was to assess overall survival (OS) and progression-free survival (PFS). Secondary objectives included the identification of predictors of treatment response. RESULTS: Overall, 297 patients were identified. Median OS was 10.8 months (95% confidence interval [CI] 9.3-12.2), whereas median PFS was 4.8 months (95% CI 4.3-5.5). On multivariable analysis, independent unfavourable prognostic factors for OS were performance status (PS) Eastern Cooperative Oncology Group (ECOG) >0, presence of residual tumour at primary site, platinum resistance and lack of objective response. Unfavourable predictors for PFS included cancer primary site (paranasal sinuses, hypopharynx), PS ECOG >0, presence of residual tumour at primary site, platinum resistance and lack of objective response. Independent unfavourable predictors of objective response were tumour site (oral cavity, larynx-hypopharynx), residual tumour at primary site and prior chemotherapy. CONCLUSIONS: The availability of new treatment modalities and epidemiological changes make the periodic reassessment of prognostic factors of great relevance to guide clinical practice and the design of future randomised clinical trials.
AIM: The aims of the study are to evaluate the clinical outcomes of first-line treatment with platinum-based chemotherapy and cetuximab in patients with relapsing/metastatic head and neck cancer (RM HNC) and to identify predictors of treatment response. METHODS: This is a retrospective, observational, longitudinal, real-world study involving 6 oncology centres in Italy. All consecutive patients with RM HNC treated between January 2007 and December 2016 with a first-line therapy consisting of a platinum-based chemotherapy regimen plus cetuximab were included. The primary objective of the study was to assess overall survival (OS) and progression-free survival (PFS). Secondary objectives included the identification of predictors of treatment response. RESULTS: Overall, 297 patients were identified. Median OS was 10.8 months (95% confidence interval [CI] 9.3-12.2), whereas median PFS was 4.8 months (95% CI 4.3-5.5). On multivariable analysis, independent unfavourable prognostic factors for OS were performance status (PS) Eastern Cooperative Oncology Group (ECOG) >0, presence of residual tumour at primary site, platinum resistance and lack of objective response. Unfavourable predictors for PFS included cancer primary site (paranasal sinuses, hypopharynx), PS ECOG >0, presence of residual tumour at primary site, platinum resistance and lack of objective response. Independent unfavourable predictors of objective response were tumour site (oral cavity, larynx-hypopharynx), residual tumour at primary site and prior chemotherapy. CONCLUSIONS: The availability of new treatment modalities and epidemiological changes make the periodic reassessment of prognostic factors of great relevance to guide clinical practice and the design of future randomised clinical trials.
Authors: Olivia Leblanc; Sophie Vacher; Charlotte Lecerf; Emmanuelle Jeannot; Jerzy Klijanienko; Frédérique Berger; Caroline Hoffmann; Valentin Calugaru; Nathalie Badois; Anne Chilles; Maria Lesnik; Samar Krhili; Ivan Bieche; Christophe Le Tourneau; Maud Kamal Journal: Cancer Biol Med Date: 2020-02-15 Impact factor: 4.248