Palliative treatment standards for head and neck squamous cell carcinoma

Laban, Simon; Kimmeyer, J.; Knecht, Rainald; Hoffmann, Thomas; Busch, Chia‐Jung; Veit, J.; Möckelmann, Nikolaus; Kurzweg, T.

doi:10.1007/s00106-016-0187-x

Cited by 4 publications

(3 citation statements)

References 18 publications

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“…Platinum-based combinations were most frequently used as first-line therapy (71.4%). Due to a recent survey on palliative treatment for head and neck cancer, the EXTREME protocol was the institutional standard of care for first-line treatment in most centers in Germany in the period of the present study (Laban et al 2016 ). Nevertheless, the EXTREME protocol was used only for 32.9% of the patients for first-line systemic therapy.…”

Section: Discussionmentioning

confidence: 99%

“…A web-based survey performed between 2013 and 2014 on palliative treatment for head and neck cancer in German-speaking countries also revealed a large variation but no standards especially for second- and third-line treatments. The authors assume that reasons for this could be the physicians’ individual experience as well as the varying assessment regarding the toxicity of palliative systemic therapy (Laban et al 2016 ). The valid NCCN guidelines for the years 2015–2018 clearly favored a combination of platinum, 5-FU, and cetuximab ahead of other combinations or a single-agent option (Adelstein et al 2017 ).…”

Section: Discussionmentioning

confidence: 99%

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Systemic therapy for recurrent and/or metastatic head and neck cancer: a population-based healthcare research study in Thuringia, Germany

Morkramer

Geitner

Boeger

et al. 2021

J Cancer Res Clin Oncol

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Purpose Systemic therapy choice for patients with recurrent and/or metastatic head and neck cancer (R/M HNC) is a challenge. Not much is known about systemic therapies used in daily clinical routine and their outcome. Methods Data of all 283 patients with R/M HNC (89.4% male, median age: 60 years) registered for first-line systemic therapy between 2015 and 2018 in the cancer registries of Thuringia, a federal state in Germany, were included. Patient characteristics and treatment patterns were summarized. Exploratory univariate and multivariate analyses were conducted on select of systemic therapy and prognostic factors for overall survival. Results The most frequent first-line regimens were platinum-based combinations (71.4%), mainly cetuximab + platinum + 5-fluorouracil (32.5%). 32.5, 13.1, 4.9, and 1.1%, respectively, received, a second, third, fourth, and fifth line of systemic therapy. Median follow-up was 5.5 months. Median real-world overall survival was 16.8 months [95% confidence interval (CI) 11.1–22.6]. Alcohol drinking [hazard ratio (HR) 2.375, CI 1.471–3.831; p < 0.001], no second-line therapy (HR 3.425, CI 2.082–5.635, p < 0.001), and application of three agents compared to one agent in first-line therapy (HR 2.798, CI 1.374–5.697; p = 0.005) were associated to decreased overall survival after start of first-line systemic therapy. Termination of second-line treatment because of deterioration of the general condition was the only independent negative prognostic factor (HR 4.202, CI 1.091–16.129; p = 0.037) after start of second-line systemic therapy. Conclusions This study offers useful information, mainly prior to the availability of immunotherapy, on patient characteristics, treatment patterns, and survival in a German real-world population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Systemic therapy for recurrent and/or metastatic head and neck cancer: a population-based healthcare research study in Thuringia, Germany

Morkramer

Geitner

Boeger

et al. 2021

J Cancer Res Clin Oncol

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“…This is important because docetaxel was also determined to be the most efficacious of the SOC therapies in both KEYNOTE-040 and CheckMate 141 (16). In addition, in situations in which anti-PD-1 therapy is not available to patients, docetaxel is the most likely therapy to be administered in realworld practice (37)(38)(39)(40)(41). These data evaluating PD-1 inhibitors versus docetaxel are consistent with results from NSCLC in KEYNOTE-010; patients treated with pembrolizumab versus docetaxel showed improved survival and HRQoL (42,43).…”

Section: Discussionmentioning

confidence: 99%

Quality of Life With Pembrolizumab for Recurrent and/or Metastatic Head and Neck Squamous Cell Carcinoma: KEYNOTE-040

Harrington

Soulières

Tourneau

et al. 2020

JNCI: Journal of the National Cancer Institute

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Background Head and neck squamous cell carcinoma (HNSCC) affects health-related quality of life (HRQoL); few treatments have demonstrated clinically meaningful HRQoL benefit. KEYNOTE-040 evaluated pembrolizumab versus standard of care (SOC) in patients with recurrent/metastatic (R/M) HNSCC whose disease recurred/progressed after platinum-containing regimen. Methods Patients received pembrolizumab 200 mg or SOC (methotrexate, docetaxel, or cetuximab). Exploratory HRQoL analyses used European Organisation for Research and Treatment of Cancer (EORTC) 30 quality-of-life, EORTC 35-question quality-of-life head and neck cancer-specific module, and EuroQoL 5-dimensions questionnaires. Results HRQoL population comprised 469 patients (pembrolizumab=241, SOC=228). HRQoL compliance for patients on study at week 15 was 75.3% (116/154) for pembrolizumab and 74.6% (85/114) for SOC. Median time to deterioration in global health status (GHS)/QoL score was 4.8 months and 2.8 months, respectively (HR, 0.79; 95% CI: 0.59, 1.05). At week 15, GHS/QoL scores were stable for pembrolizumab (least squares mean [LSM], 0.39; 95% CI: –3.00, 3.78) but worsened for SOC (LSM, –5.86; 95% CI: –9.68, –2.04); LSM between-group difference was 6.25 points (95% CI: 1.32, 11.18; nominal 2-sided P=.01). Greater difference in LSM score for GHS/QoL occurred with pembrolizumab versus docetaxel (10.23; 95% CI: 3.15, 17.30) compared with pembrolizumab versus methotrexate (6.21; 95% CI: -4.57, 16.99) or pembrolizumab versus cetuximab (–1.44; 95% CI: -11.43, 8.56). Pembrolizumab-treated patients had stable functioning and symptoms at week 15, with no notable differences from SOC. Conclusions GHS/QoL was stable with pembrolizumab but declined with SOC in patients at week 15, supporting the clinically meaningful benefit of pembrolizumab in R/M HNSCC.

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Global treatment patterns and outcomes among patients with recurrent and/or metastatic head and neck squamous cell carcinoma: Results of the GLANCE H&N study

et al. 2020

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Palliative treatment standards for head and neck squamous cell carcinoma

Cited by 4 publications

References 18 publications

Systemic therapy for recurrent and/or metastatic head and neck cancer: a population-based healthcare research study in Thuringia, Germany

Systemic therapy for recurrent and/or metastatic head and neck cancer: a population-based healthcare research study in Thuringia, Germany

Quality of Life With Pembrolizumab for Recurrent and/or Metastatic Head and Neck Squamous Cell Carcinoma: KEYNOTE-040

Global treatment patterns and outcomes among patients with recurrent and/or metastatic head and neck squamous cell carcinoma: Results of the GLANCE H&N study

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