Real-world outcomes and prognostic factors in patients receiving nivolumab therapy for recurrent or metastatic head and neck carcinoma

Ryusuke Hori, Shogo Shinohara, Tsuyoshi Kojima, Hiroki Kagoshima, Morimasa Kitamura, Ichiro Tateya, Hisanobu Tamaki, Yohei Kumabe, Ryo Asato, Hiroyuki Harada, Yoshiharu Kitani, Takashi Tsujimura, Keigo Honda, Kazuyuki Ichimaru, Koichi Omori

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16 Citations (Scopus)

Abstract

Recently, a global phase III study demonstrated that nivolumab markedly improved patient outcomes in recurrent or metastatic head and neck carcinoma (RMHNC). However, the effcacy of nivolumab in patients who are ineligible for clinical trials is unknown. We investigated nivolumab eeecacy in real-world patients and prognostic factors associated with the response to nivolumab. This study was conducted at 11 institutes associated with Kyoto University and its Affliated Hospitals-Head and Neck Oncology Group. In total, 95 patients withRMHNCwho received nivolumab between May 2017 and May 2018 were retrospectively reviewed. Objective response rate (ORR), overall survival, and progression-free survival (PFS) were evaluated. Univariate and multivariate analyses were performed to identify prognostic factors. The ORRs in patients with squamous cell carcinoma (SCC) and non-SCC were 21.8% and 0%, respectively. In patients with SCC and non-SCC, the 1-year PFS rates were 28.7% and 8.9%, respectively. The hazard ratio (HR) for risk of PFS events (SCC versus non-SCC) was 2.28 (95% confidence interval: 1.21–4.1; log-rank p = 0.007). Univariate and multivariate analyses revealed radiotherapy history, platinum-refractory carcinoma, and treatment-related adverse events (TRAEs) as important prognostic factors associated with PFS in patients with SCC. In a real-world setting, non-SCC and platinum-refractory carcinoma were associated with a poorer prognosis, and a history of radiotherapy to the primary tumor, and the occurrence of TRAEs were associated with a better prognosis. These findings could be useful for clinicians and patients when selecting a treatment strategy.

Original languageEnglish
Article number1317
JournalCancers
Volume11
Issue number9
DOIs
Publication statusPublished - 09-2019
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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