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. 2022 May 6;7(3):757-765.
doi: 10.1002/lio2.807. eCollection 2022 Jun.

Definitive local therapy to head and neck squamous cell carcinoma with distant metastasis

Steven Borson  1 , Yongli Shuai  1 , Barton F Branstetter  2 , Marci Lee Nilsen  3 , Marion A Hughes  2 , Moon Fenton  1 , Mark Kubik  4 , Shaum Sridharan  4 , David A Clump  5 , Heath D Skinner  5 , Jonas T Johnson  5 , Simion I Chiosea  6 , James Ohr  4 , Umamaheswar Duvvuri  4 , Seungwon Kim  4 , Katie S Traylor  2 , Robert Ferris  4 , Dan P Zandberg  7
Affiliations

Definitive local therapy to head and neck squamous cell carcinoma with distant metastasis

Steven Borson et al. Laryngoscope Investig Otolaryngol. .

Abstract

Objectives: Data on the efficacy of including definitive local therapy to the primary site for head and neck squamous cell carcinoma (HNSCC) patients with synchronous distant metastasis are lacking. In multiple different solid tumor types, there has been benefit when using systemic therapy followed by local consolidative therapy (stereotactic ablative radiotherapy or surgery) directed at metastases. We proposed to retrospectively evaluate patients at our institution that received definitive treatment to the primary.

Methods: Single institution retrospective study evaluating 40 patients with metastatic HNSCC treated with definitive surgery (55%) or chemoradiation (45%) to the primary site from 2000 to 2020. The major endpoints were overall survival (OS) and progression-free survival (PFS) for the total population and multiple sub-groups. Some variables were evaluated with multiple covariates Cox model.

Results: The median PFS was 8.6 months (95% CI, 6.4-11.6), and OS was 14.2 months (95% CI, 10.9-27.5). In 28% of patients that received induction therapy, there was a twofold increase in median overall survival to 27.5 months. In the 33% of patients that received anti-PD-1 mAb as part of their treatment course, the median OS was significantly increased to 41.7 months (95% CI, 8.7-NR) versus 12.1 months (95% CI, 8.4-14.4) with a 5-year OS of 39%. Multivariate analysis for OS showed significance for age at diagnosis, use of IO, and number of metastatic sites.

Conclusion: We observed impressive survival outcomes in metastatic HNSCC patients treated with definitive local therapy to the primary site in addition to induction and/or immunotherapy. Further study is warranted.Level of Evidence: 3.

Keywords: head and neck cancer; immunotherapy; oligometastatic.

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Conflict of interest statement

Dr. Robert L. Ferris, MD, PhD: Aduro Biotech, Inc: Consulting; Astra‐Zeneca/MedImmune: Clinical Trial, Research Funding; Bristol‐Myers Squibb: Advisory Board, Clinical Trial, Research Funding; EMD Serono: Advisory Board; MacroGenics, Inc.: Advisory Board; Merck: Advisory Board, Clinical Trial; Novasenta: Consulting, Stock, Research Funding; Numab Therapeutics AG: Advisory Board; Pfizer: Advisory Board; Tesaro: Research Funding. Dr. Dan Zandberg, MD: Research support (institutional) for role as principal investigator for clinical trials with Merck, Bristol Myers‐Squibb, AstraZeneca, Aduro, ISA Therapeutics, Astelles, Glaxo Smith‐Kline, and Regeneron. All other authors have no conflicts to disclose.

Figures

FIGURE 1
FIGURE 1
Survival outcomes for the total population. (A) Progression free survival. (B) Overall survival.
FIGURE 2
FIGURE 2
Overall survival for patients treated with induction therapy.
FIGURE 3
FIGURE 3
Survival outcomes for patients treatment with immunotherapy. (A) Progression free survival. (B) Overall survival.
See this image and copyright information in PMC

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