The primary site of head and neck squamous cell carcinoma predicts survival benefits of EGFR inhibitors: A systematic review and meta-analysis

Abstract

Background and purpose: To assess the survival benefits associated with epidermal growth factor receptor (EGFR) inhibitors in head and neck squamous cell carcinoma (HNSCC) according to the primary site. Materials and methods: A systematic review and meta-analysis were conducted for randomized phase III trials comparing treatment with or without EGFR inhibitors in locoregionally advanced, recurrent, or metastatic HNSCC. The primary and secondary endpoints were overall survival (OS) and progressionfree survival (PFS), respectively. Data were pooled using a random-effects model. Results: Seven trials with a total of 3391 patients were included. The addition of EGFR inhibitors improved OS in patients with oral cavity-oropharyngeal carcinoma (hazard ratio [HR] 0.77, 95% confidence interval [CI] 0.67-0.87, P < 0.001) but not in patients with hypopharyngeal-laryngeal carcinoma (HR 0.94, 95% CI 0.82-1.08, P = 0.398). A significant interaction was found in favor of oral cavityoropharyngeal carcinoma (P = 0.029). The addition of EGFR inhibitors increased PFS in both patients with oral cavity-oropharyngeal carcinoma (HR 0.67, 95% CI 0.52-0.85, P = 0.001) and patients with hypopharyngeal-laryngeal carcinoma (HR 0.81, 95% CI 0.69-0.94, P = 0.005). A trend towards significant interaction was found in favor of oral cavity-oropharyngeal carcinoma (P = 0.161). Comparable results were observed in the pre-specified subgroup analyses. Meta-regression analyses suggested that the primary site appeared to be a predictor of survival benefits in HNSCC patients who received treatment with EGFR inhibitors over those who did not. Conclusion: Our meta-analysis suggests that the survival benefits of EGFR inhibitors might depend on primary sites in HNSCC. Further studies are needed to confirm this finding.

Personalized Medicine in Oral Oncology: Imaging Methods and Biological Markers to Support Diagnosis of Oral Squamous Cell Carcinoma (OSCC): A Narrative Literature Review

“…EGFR is, in fact, overexpressed in OSCC, which is associated with poor prognosis [ 149 , 150 , 151 ]. The evidence is such that several studies proposed anti-EGFR target therapies [ 152 , 153 ].…”

Hallmarks of Cancer Applied to Oral and Oropharyngeal Carcinogenesis: A Scoping Review of the Evidence Gaps Found in Published Systematic Reviews

“…The available data suggest that ErbB2 receptor overexpression is associated with poor overall survival, poor disease-specific survival and poor disease-free survival, N+ status and advanced stage [ 41 , 73 ]. Likewise, one study suggests that EGFR inhibition slightly improves survival compared to conservative therapy [ 108 ], and another [ 65 ] shows that ErbB mutations are extremely rare in oral oncogenesis (0.41% of oral cancer cases analysed have mutations).…”

TUFM in health and disease: exploring its multifaceted roles

“…Current studies show that blocking epidermal growth factor receptor (EGFR) inhibits HNSCC initiation and maintenance ( 84 ), with the inhibition of autophagy sensitizing HNSCC to EGFR blockade ( 85 ). Regarding TUFM, a reduction in its expression is associated with a poor response to EGFR inhibitor cetuximab or gefitinib treatment ( 86 ).…”