Impact of salvage chemotherapy after immune checkpoint inhibitor for recurrent or metastatic head and neck cancer

Head Neck. 2024 Jan 16. doi: 10.1002/hed.27643. Online ahead of print.

Abstract

Background: It is unclear witch regimen is optimal as salvage chemotherapy (SCT) after immune checkpoint inhibitor (ICI) monotherapy for recurrent or metastatic head and neck cancer (RM-HNC).

Methods: This study enrolled 109 patients. Overall survival (OS) and progression-free survival 2 (PFS2) were compared between patients stratified by SCT regimen.

Results: Of the 109 patients, 55 underwent SCT after the failure of ICI monotherapy. The OS of these 55 patients was longer than that of patients who did not undergo SCT. The OS and PFS2 were similar between patients treated with paclitaxel (PTX) and cetuximab (Cmab) combination and those treated with PTX monotherapy. The occurrence of irAEs did not impact PFS2 nor OS.

Conclusions: SCT can improve the survival outcomes of patients with RM-HNC. In addition to PTX and Cmab, PTX monotherapy is also considered an effective SCT regimen. SCT is effective regardless of the presence or absence of irAEs.

Keywords: head and neck cancer; immune checkpoint inhibitor; immune-related adverse effects; paclitaxel monotherapy; salvage chemotherapy.