Durvalumab for recurrent or metastatic head and neck squamous cell carcinoma

Background: Patients with recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) progressing on platinum-based chemotherapy have poor prognoses and limited therapeutic options. Programmed cell death-1 (PD-1) and its ligand 1 (PD-L1) are frequently upregulated in HNSCC. The internatio...

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Detalles Bibliográficos
Autores: Zandberg, Dan P., Algazi, Alain P., Jimeno, Antonio, Good, James S., Fayette, Jérôme, Bouganim, Nathaniel, Ready, Neal E., Clement, Paul M., Even, Caroline, Jang, Raymond W., Wong, Stuart, Keilholz, Ulrich, Gilbert, Jill, Fenton, Moon, Braña, Irene|||0000-0002-1068-9601, Henry, Stephanie, Remenar, Eva, Papai, Zsuzsanna, Siu, Lillian L.|||0000-0002-3500-0540, Jarkowski, Anthony, Armstrong, Jon M., Asubonteng, Kobby, Fan, Jean, Melillo, Giovanni, Mesia, Ricard|||0000-0002-3785-3563
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:224127
Acceso en línea:https://ddd.uab.cat/record/224127
https://dx.doi.org/urn:doi:10.1016/j.ejca.2018.11.015
Access Level:acceso abierto
Palabra clave:Antibodies
HPV
Head and neck cancer
Immunotherapy
Monoclonal
Recurrent or metastatic
Survival rate
Descripción
Sumario:Background: Patients with recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) progressing on platinum-based chemotherapy have poor prognoses and limited therapeutic options. Programmed cell death-1 (PD-1) and its ligand 1 (PD-L1) are frequently upregulated in HNSCC. The international, multi-institutional, single-arm, phase II HAWK study (NCT02207530) evaluated durvalumab monotherapy, an anti-PD-L1 monoclonal antibody, in PD-L1-high patients with platinum-refractory R/M HNSCC. Patients and methods: Immunotherapy-naïve patients with confirmed PD-L1-high tumour cell expression (defined as patients with ≥25% of tumour cells expressing PD-L1 [TC ≥ 25%] using the VENTANA PD-L1 [SP263] Assay) received durvalumab 10 mg/kg intravenously every 2 weeks for up to 12 months. The primary end-point was objective response rate; secondary end-points included progression-free survival (PFS) and overall survival (OS). Results: Among evaluable patients (n = 111), objective response rate was 16.2% (95% confidence interval [CI], 9.9-24.4); 29.4% (95% CI, 15.1-47.5) for human papillomavirus (HPV)-positive patients and 10.9% (95% CI, 4.5-21.3) for HPV-negative patients. Median PFS and OS for treated patients (n = 112) was 2.1 months (95% CI, 1.9-3.7) and 7.1 months (95% CI, 4.9-9.9); PFS and OS at 12 months were 14.6% (95% CI, 8.5-22.1) and 33.6% (95% CI, 24.8-42.7). Treatment-related adverse events were 57.1% (any grade) and 8.0% (grade ≥3); none led to death. At data cut-off, 24.1% of patients remained on treatment or in follow-up. Conclusion: Durvalumab demonstrated antitumour activity with acceptable safety in PD-L1-high patients with R/M HNSCC, supporting its ongoing evaluation in phase III trials in first- and second-line settings. In an ad hoc analysis, HPV-positive patients had a numerically higher response rate and survival than HPV-negative patients.

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