Progression beyond nivolumab: Stop or repeat? Dramatic responses with salvage chemotherapy

Daste, Amaury; De-Mones, E.; Cochin, Valérie; Dupin, Charles; Digue, Laurence; Ravaud, Alain; Domblides, Charlotte

doi:10.1016/j.oraloncology.2018.04.013

Cited by 17 publications

(8 citation statements)

References 5 publications

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“…5,6 Moreover, the prolonged benefit from palliative reirradiation in the first clinical case confirms the big amount of data on higher radiosensitivity after immunotherapy. Our data as well as those presented by Daste in 2018 and Aspeslagh in 2017 (2 and 13 patients with recurrent or metastatic HNSCC) highlight an interesting perspective, supporting assessment for at least sequential treatment of chemotherapy after anti-PD-L1/PD-1 therapy in this population.…”

Section: Discussionmentioning

confidence: 59%

“…Our data as well as those presented by Daste in 2018 and Aspeslagh in 2017 (2 and 13 patients with recurrent or metastatic HNSCC) highlight an interesting perspective, supporting assessment for at least sequential treatment of chemotherapy after anti-PD-L1/PD-1 therapy in this population. 5,6 Moreover, the prolonged benefit from palliative reirradiation in the first clinical case confirms the big amount of data on higher radiosensitivity after immunotherapy. 7 In our clinical cases, the administration of palliative reirradiation (first patient) or weekly carboplatin/paclitaxel (second and third patients), even as second-line or third-line therapy, resulted in a rapid regression of nivolumabrefractory disease.…”

Section: Discussionmentioning

confidence: 59%

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Unexpected response with palliative conventional therapy in head and neck squamous cell carcinoma after anti‐programmed death‐1 progression

Denaro

Merlano

2019

Head & Neck

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Background The application of anti‐programmed death‐1 (PD‐1) therapies for recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) has found promising results. It is the first “second‐line therapy” in this setting to impact on prognosis. The studies demonstrated overall response rates in the range of 20%. Therefore, HNSCC showed 60%‐80% progression at first evaluation with better overall survival, suggesting regained efficacy of treatments given thereafter. Methods We report three clinical cases treated with anti‐PD‐1 after platinum‐based chemotherapy. Results Our case reports achieved an unforeseen response to conventional therapies supporting the hypothesis of restored responses to conventional therapies after immunotherapy. Conclusions We believe that the inhibition of the PD‐1/PD‐ligand 1 checkpoint may synergize with both chemotherapy or radiotherapy through immunologic interplay, reversing the HNSCC‐induced immune suppression.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 59%

Unexpected response with palliative conventional therapy in head and neck squamous cell carcinoma after anti‐programmed death‐1 progression

Denaro

Merlano

2019

Head & Neck

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“…Dans le cancer du poumon non à petites cellules sans drivers oncogéniques ciblables, les taux de réponses au monochimiothérapies de rattrapage (dont 50% de docétaxel) s'élèvent à 39% ce qui est supérieur aux données de l'ère pré immunothérapie (de l'ordre de 8%) 56 L'étude spécifique des taxanes après anti PD1 n'a pas été réalisée et depuis l'utilisation du nivolumab en deuxième ligne, plusieurs cas de réponses complètes ou partielles majeures aux taxanes en monothérapie sont décrits chez des patients atteints de CEVADS R/M [67][68][69] . Ainsi, nous avons voulu étudier l'effet du nivolumab sur les taxanes en monothérapies sur une plus large cohorte.…”

Section: Cancer Pulmonaireunclassified

Impact of previous nivolumab treatment on the response to taxanes in patients with recurrent/metastatic head and neck squamous cell carcinoma

Guiard

Clatot

Even

et al. 2021

European Journal of Cancer

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“…Retrospective series and case reports in lung cancer and in other entities have shown increased responses to salvage chemotherapy after immunotherapy (SCAI) [9][10][11][12][13][14][15][16][17][18]. However, data demonstrating such responses in SCCHN are still limited, particularly when using anti-EGFR-based chemotherapy [13,16,[19][20][21][22][23][24]. Our aim was to retrospectively study the safety and efficacy of salvage chemotherapy combined with cetuximab after progression to ICIs in patients with R/M SCCHN.…”

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of Cetuximab-Based Salvage Chemotherapy After Checkpoint Inhibitors in Head and Neck Cancer

et al. 2021

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Background. There are still few data on the activity and safety of cetuximab-based salvage chemotherapy after immunotherapy (SCAI) in patients with squamous cell cancer of the head and neck (SCCHN). Materials and Methods. Retrospective study of patients with SCCHN who received cetuximab-based SCAI after PD1 or PDL1 (PD(L)1) inhibitors. Overall response rate (ORR) and disease control rate (DCR) with SCAI and with last chemotherapy before immunotherapy (LCBI) by RECIST 1.1, percentage change from baseline in target lesions (PCTL), progression-free survival (PFS), overall survival (OS), treatment compliance and toxicity were evaluated. Results. Between March 2016 and November 2019, 23 patients were identified. SCAI consisted of cetuximabbased combinations (3wkCDDP-5FU-Cetuximab (n=2), wkPaclitaxel-Cetuximab (n=17), wkCDDP-Cetuximab (n=2), wkCBDCA-Paclitaxel-Cetuximab (n=2)). ORR was 56.5% (11 partial response (PR), 2 complete response (CR)). DCR was 78.3%. Among 13 objective responders, median best PCTL was-53.5% (range:-30% to-100%). Median OS and PFS were 12m and 6m, respectively. In 10 patients receiving LCBI, ORR to LCBI was 40%, while ORR to SCAI achieved 60%. In LCBI-treated patients median PFS with LCBI was 8m and median PFS and OS with SCAI were 7m and 12m, respectively. Reduced dose intensity of the chemotherapy and cetuximab components occurred in 82.6% and 52.2% of the patients. Grade 1 or 2 AEs occurred in all patients. Grade 3 or 4 AEs developed in 65%, being grade 3 in all of them except in one patient (grade 4 neutropenia). There were no treatment-related deaths. Conclusion. Cetuximab-based salvage chemotherapy after PD(L)1 inhibitors associated with high response rates and deep tumor reductions with a manageable safety profile. Subsequent lines of therapy may explain the long survival achieved in our series. These results invite to design studies to elucidate the best therapeutic sequence in patients with SCCHN in the immunotherapy era. The Oncologist 2021;9999:• • Implications for Practice: Cetuximab-based salvage chemotherapy (SCAI) achieved high response rates in patients with R/M SCCHN after progression to PD1/PDL1 inhibitors. Objective response rate was higher and progression-free survival was comparable to that of chemotherapy administered before immunotherapy (IO). In most patients, SCAI consisted of weekly, welltolerated regimens. These observations have implications for current practice due to the limited evidence to date in SCCHN and the scant therapeutic options in this disease, and invite to elucidate which may be the best treatment sequence for head and neck cancer patients in the IO era.

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Progression beyond nivolumab: Stop or repeat? Dramatic responses with salvage chemotherapy

Cited by 17 publications

References 5 publications

Unexpected response with palliative conventional therapy in head and neck squamous cell carcinoma after anti‐programmed death‐1 progression

Unexpected response with palliative conventional therapy in head and neck squamous cell carcinoma after anti‐programmed death‐1 progression

Impact of previous nivolumab treatment on the response to taxanes in patients with recurrent/metastatic head and neck squamous cell carcinoma

Safety and Efficacy of Cetuximab-Based Salvage Chemotherapy After Checkpoint Inhibitors in Head and Neck Cancer

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