Ashley Lau1, Wei-Fa Yang1, Kar-Yan Li1, Yu-Xiong Su2. 1. Department of Oral and Maxillofacial Surgery, Prince Phillip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong Special Administrative Region. 2. Department of Oral and Maxillofacial Surgery, Prince Phillip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong Special Administrative Region. Electronic address: richsu@hku.hk.
Abstract
BACKGROUND: The most effective regimen is unclear for patients with recurrent or metastatic head and neck squamous cell carcinomas (R/M HNSCC). We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating only systemic therapy for R/M HNSCC. METHODS: This systematic review followed PRISMA and the Cochrane Collaboration Handbook for Systematic Reviews of Interventions. Endpoints included overall survival (OS), progression-free survival (PFS) and overall response rates (ORR). RESULTS: 55 RCTs from 1990-November 2019 qualified for review (n=12132). Only PD-1/PDL-1 inhibitors increased OS in R/M HNSCC platinum-resistant disease against their control (HR = 0·79, 95%CI 0·70-0.90, p<0·001), especially for PD-L1 ≥ 1% expressing tumours (HR = 0·72, 95%CI 0·60-0·86, p<0·001). PFS was prolonged for anti-EGFR agents against methotrexate when used in a second line setting (HR = 0·74, 95 %CI 0·62-0·87, p=0·001), and when cetuximab (HR = 0·60, 95%CI 0·49-0·72, p<0·0001) and panitumumab (HR = 0·76, 95%CI 0·65-0·89, p=0·001) were introduced to platinum-based regimens for first-line treatment. CONCLUSIONS: PD-1/PD-L1 inhibitors may represent the future of R/M HNSCC treatment. However, EGFR inhibitors may still play improve clinical outcomes.
BACKGROUND: The most effective regimen is unclear for patients with recurrent or metastatic head and neck squamous cell carcinomas (R/M HNSCC). We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating only systemic therapy for R/M HNSCC. METHODS: This systematic review followed PRISMA and the Cochrane Collaboration Handbook for Systematic Reviews of Interventions. Endpoints included overall survival (OS), progression-free survival (PFS) and overall response rates (ORR). RESULTS: 55 RCTs from 1990-November 2019 qualified for review (n=12132). Only PD-1/PDL-1 inhibitors increased OS in R/M HNSCC platinum-resistant disease against their control (HR = 0·79, 95%CI 0·70-0.90, p<0·001), especially for PD-L1 ≥ 1% expressing tumours (HR = 0·72, 95%CI 0·60-0·86, p<0·001). PFS was prolonged for anti-EGFR agents against methotrexate when used in a second line setting (HR = 0·74, 95 %CI 0·62-0·87, p=0·001), and when cetuximab (HR = 0·60, 95%CI 0·49-0·72, p<0·0001) and panitumumab (HR = 0·76, 95%CI 0·65-0·89, p=0·001) were introduced to platinum-based regimens for first-line treatment. CONCLUSIONS:PD-1/PD-L1 inhibitors may represent the future of R/M HNSCC treatment. However, EGFR inhibitors may still play improve clinical outcomes.
Authors: Franco Ionna; Paolo Bossi; Agostino Guida; Andrea Alberti; Paolo Muto; Giovanni Salzano; Alessandro Ottaiano; Fabio Maglitto; Davide Leopardo; Marco De Felice; Francesco Longo; Salvatore Tafuto; Giuseppina Della Vittoria Scarpati; Francesco Perri Journal: Cancers (Basel) Date: 2021-05-14 Impact factor: 6.639
Authors: Giampiero Ferraguti; Sergio Terracina; Carla Petrella; Antonio Greco; Antonio Minni; Marco Lucarelli; Enzo Agostinelli; Massimo Ralli; Marco de Vincentiis; Giammarco Raponi; Antonella Polimeni; Mauro Ceccanti; Brunella Caronti; Maria Grazia Di Certo; Christian Barbato; Alessandro Mattia; Luigi Tarani; Marco Fiore Journal: Antioxidants (Basel) Date: 2022-01-11