Full text

Turn on search term navigation

© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Simple Summary

This retrospective study aimed to determine the optimal timing of active discontinuation of long-term responders to immune checkpoint inhibitors in patients with recurrent/metastatic head and neck squamous cell carcinoma. We analyzed treatment duration and treatment-free interval (TFI) in 227 nivolumab-treated patients and determined the timing when progression-free survival (PFS) leveled off and when patients discontinued for unplanned reasons (toxicity or patient decision). The 3-year and 6-year PFS was 15.9% and 15.3%, respectively. The PFS curve was completely flat at 3 years. The median time for patients to request discontinuation was 36.8 months, with a median TFI of 15.1 months. The median time for discontinuation due to toxicity was 18.9 months, with a median TFI of 30.6 months. Given that the PFS curve completely leveled off at 3 years and the median time of discontinuation at the patient’s choice was 3 years, we suggest considering treatment completion at 3 years.

Abstract

The optimal timing for actively discontinuing immune checkpoint inhibitor therapy in long-term responders with recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) remains unresolved. We conducted a retrospective study of 246 patients with R/M HNSCC treated with nivolumab to determine the optimal timing to actively discontinue nivolumab therapy. We examined the point at which progression-free survival (PFS) plateaued in all cases. We compared the prognosis of 19 (7.7%) ongoing cases and 227 (92.3%) discontinued cases and analyzed treatment duration and treatment-free interval (TFI). The 6-year overall survival was 11.8% (median, 12.1), and the 6-year PFS was 15.3% (median, 3.0). The PFS curve remained stable for 3 years. The median duration of nivolumab treatment was 2.9 months (range 0.03–81.9): Ongoing group, 41.8 (5.6–81.9); Decision group, 36.8 (4.0–70.1); Toxicity group, 30.6 (2.8–64.8); and progressive disease group, 2.0 (0.03–42.9). TFI in the Decision group was 15.1 months (0.6–61.6) and 30.6 months (2.8–64.8) in the Toxicity group. Long-term responses in R/M HNSCC patients treated with nivolumab are rare but gradually increasing. For this patient group, our best estimate of the optimal time to end treatment is 3 years, as the PFS in this study reached a plateau at that timepoint.

Details

Title
Progression-Free Survival and Treatment-Free Interval in Head and Neck Cancer with Long-Term Response to Nivolumab: Timing of Active Discontinuation
Author
Matsuo, Mioko 1   VIAFID ORCID Logo  ; Masuda, Muneyuki 2 ; Yamauchi, Moriyasu 3   VIAFID ORCID Logo  ; Hashimoto, Kazuki 1 ; Kogo, Ryunosuke 1   VIAFID ORCID Logo  ; Sato, Masanobu 1 ; Masuda, Shogo 1 ; Nakagawa, Takashi 1 

 Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; [email protected] (K.H.); [email protected] (R.K.); [email protected] (M.S.); [email protected] (S.M.); [email protected] (T.N.) 
 Department of Head and Neck Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan; [email protected] 
 Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan; [email protected] 
First page
2527
Publication year
2024
Publication date
2024
Publisher
MDPI AG
e-ISSN
20726694
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3084728610
Copyright
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.