First-Line Therapy in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: A Retrospective, Multicenter,...

Area of Science:

• Oncology
• Head and Neck Cancer Research
• Immunotherapy

Background:

• Current European guidelines recommend pembrolizumab-based therapies for first-line treatment of recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) with a combined positive score (CPS) ≥ 1.
• The TPExtreme (TPEx) regimen is a preferred option in France for patients with CPS < 1.
• Clinical trial data for these regimens may not fully represent the diverse characteristics of real-world patient populations.

Purpose of the Study:

• To evaluate the real-world effectiveness and safety of different first-line treatment regimens for R/M HNSCC.
• To compare progression-free survival (PFS) and overall survival (OS) across various treatment strategies in a French cohort.

Main Methods:

• Retrospective analysis of 290 R/M HNSCC patients treated between January 2021 and December 2023 in Nancy and Lille, France.
• Data collection included patient demographics, treatment regimens, survival outcomes, response rates, and safety profiles.
• Progression-free survival (PFS) and overall survival (OS) were analyzed using Cox multivariable regression, adjusting for age, ECOG performance status, comorbidities, and nutritional status.

Main Results:

• The study included 290 patients receiving pembrolizumab alone (19%), pembrolizumab with chemotherapy (28%), TPEx (19%), or adapted regimens (20%).
• Pembrolizumab combined with chemotherapy showed significantly better median PFS (6 months) and OS (15.5 months) compared to other groups.
• Pembrolizumab monotherapy was associated with the best safety profile.

Conclusions:

• This real-world study in two French cancer centers suggests that pembrolizumab in combination with chemotherapy is the most effective first-line treatment for R/M HNSCC.
• The findings support the use of pembrolizumab-chemotherapy regimens for R/M HNSCC patients in routine clinical practice.