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Choosing the Right Treatment Option for the Right R/M HNSCC Patient: Should We Adhere to PFE for First-Line Therapy?

Background: The landmark EXTREME trial established cisplatin, 5-fluorouracil and
cetuximab (PFE) as first-line chemotherapy (1L-ChT) for recurrent/metastatic head and
neck squamous cell carcinoma (R/M HNSCC). We were interested in outcome differences
of R/M HNSCC in 1L-ChT and factors influencing outcome in certain subgroups,
especially patients receiving PFE, and the value of PFE compared to other 1L-ChT
regimens to provide real world evidence (RWE).
Methods: For this retrospective monocentric study, 124 R/M HNSCC patients without
curative surgical or radiotherapy options receiving at least one cycle of 1L-ChT were
eligible. We analyzed their outcome using Kaplan-Meier plot and Cox regression to identify
predictors for prolonged survival.
Results: Subgroups benefiting significantly from PFE were patients suffering from an
index HNSCC outside the oropharynx. The PFE regimen proved to be superior to all other
1L-ChT regimens in clinical routine. Significant outcome differences between PFE
treatment within or outside controlled trials were not seen.
Conclusion: This retrospective analysis provides RWE for factors linked to improved
outcome. Subgroup analyses highlight the lasting value of PFE among the growing
spectrum of 1L-ChT. Importantly, fit smokers with high level alcohol consumption benefit
from PFE; considering the patient’s lifestyle factors, PFE should not be ignored in
decision-making.

Identiferoai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:84395
Date30 March 2023
CreatorsLübbers, Katharina, Pavlychenko, Mykola, Wald, Theresa, Wiegand, Susanne, Dietz, Andreas, Zebralla, Veit, Wichmann, Gunnar
PublisherFrontiers Research Foundation
Source SetsHochschulschriftenserver (HSSS) der SLUB Dresden
LanguageEnglish
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text
Rightsinfo:eu-repo/semantics/openAccess
Relation2234-943X, 715297

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