Impact of combined positive score in cetuximab plus chemotherapy in recurrent/metastatic head and neck cancer: A real-world study
Akhil Kapoor, Kaushal Patel, Mandapalli Venkata Chandrakanth, Vivek Agarwala, Bal Krishna Mishra, Anuj Gupta, Bipinesh Sansar, Amit Sharma, Anish Dasgupta, Minakshi Roy, Zachariah Chowdhury, Shashikant Patne, Ipsita Dhal, Satyendra Narayan Singh, Shreya Shukla, Aseem Mishra, Somnath Dey, Kunal Ranjan VinayakObjectives:
Head and neck cancers (HNCs) are a significant global health issue, particularly in India. Squamous cell carcinoma of the head and neck (SCCHN) accounts for 90% of all HNC cases and includes a diverse range of cancers originating from the lip, oral cavity, hypopharynx, nasopharynx, oropharynx, larynx, and salivary glands. This real-world study evaluated the impact of programmed cell death ligand-1 combined positive score (CPS) on treatment outcomes in Indian patients with recurrent/metastatic (R/M) SCCHN treated with cetuximab-based chemotherapy.
Material and Methods:
This retrospective real-world study analysed data from 139 patients with R/M SCCHN treated with cetuximab plus chemotherapy at three Indian oncology centres between May 2018 and September 2023. Patients were stratified into CPS <20 and CPS ≥20 groups, receiving either cetuximab with taxane-based or platinum–fluorouracil chemotherapy. Survival was estimated via the Kaplan-Meier method and compared using the log-rank test.
Results:
The overall objective response rate (ORR) was 80.6%, with similar rates across CPS groups (75.7% vs. 86.2%) and in the oral cavity subgroup. Median progression-free survival and overall survival were 9.0 and 20.0 months, respectively, with no significant differences between CPS groups in either the overall or oral cavity cohorts. Adverse events (AEs), primarily grade 3, were common and included dermatologic and gastrointestinal toxicities, with higher incidence in the oral cavity subgroup and CPS ≥20 group. However, the safety profile remained manageable.
Conclusion:
Cetuximab-based therapy may be appropriate for symptomatic patients with high tumour burden, regardless of CPS score, showing comparable survival benefits to existing data with manageable safety and no new AEs.