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Master Thesis

Impact d’un traitement par nivolumab sur la réponse aux taxanes chez les patients présentant un carcinome épidermoïde des voies aéro-digestives supérieures récidivants et/ou métastatiques

Abstract : Background: Immune checkpoints inhibitors (ICI) are widely used in recurrent and/or metastatic head and neck squamous cell carcinoma (R/M HNSCC). We aimed to describe response rates to taxanes after progression on nivolumab in R/M HNSCC patients. Methods: In this multicentric retrospective comparative study, we included patients treated with taxane monotherapy from 2014 to 2020. Patients were divided into two groups depending on whether they received nivolumab before taxanes (post-nivolumab group) or not (control group). The primary endpoint was objective response rate (ORR) comparison between the 2 groups. The secondary endpoints included disease control rate (DCR), progression free survival (PFS), overall survival (OS), and PFS ratio (PFSr=PFS associated with taxanes divided by PFS associated with the previous line of treatment), a survival marker used for comparison of different treatment lines. Results: Between July 2014 and August 2020, 185 patients were included (114 in the control group and 71 in the post-nivolumab group). ORR was significantly higher in the post-nivolumab group (39.4% versus 26.3%, p=0.03) as was DCR (69% versus 50%, p=0.06). Median OS (7.5 months) and PFS (3.5 months) were not significantly different in the two groups, whereas PFSr was significantly improved in the post-nivolumab group (1.63 versus 1.11, p=0.004). Conclusion: Response and disease control rates with taxanes are improved after prior exposure to nivolumab. Thus, taxane could be a good choice as third line therapy after nivolumab following a platinum based first line. These results currently apply to patients without access to or potential benefit from first line pembrolizumab.
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https://dumas.ccsd.cnrs.fr/dumas-03573020
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Submitted on : Monday, February 14, 2022 - 3:02:40 PM
Last modification on : Saturday, April 2, 2022 - 3:38:36 AM
Long-term archiving on: : Sunday, May 15, 2022 - 7:10:25 PM

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  • HAL Id : dumas-03573020, version 1

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Émeline Guiard. Impact d’un traitement par nivolumab sur la réponse aux taxanes chez les patients présentant un carcinome épidermoïde des voies aéro-digestives supérieures récidivants et/ou métastatiques. Médecine humaine et pathologie. 2021. ⟨dumas-03573020⟩

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