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Master Thesis

Nivolumab for recurrent or metastatic head and neck carcinoma: a retrospective and prospective real-life study

Abstract : Background: Most of the patients with HNSCC have many comorbidities linked to consump-tion of tobacco and alcohol, making them a fragile population. The inclusion criteria of clinical trials select only part of this population. A real-life study seems essential to confirm the efficacy and safety of nivolumab for recurrent or metastatic HNSCC after platinum chemotherapy. Methods: In this bicentric retrospective and prospective study, we included patients with a recur-rent or metastatic HNSCC in progression after a platinum chemotherapy treated by nivolumab between December 2017 and November 2020. The primary end point was the objective re-sponse rate. The secondary end points were overall survival, median time until progression, safety, identification of predictive factors of response and the duration of response of chemo-therapy after nivolumab exposure. Results: Ninety-five patients were included. The overall response rate was 22% including 5 complete responses with a median time until progression of 3 months. The median overall survival was 8 months and the 1-year survival rate was 38%. Performance status of 0 or 1 (OR 7,11; 95% CI [1,53-33,05]; p = 0,012), cisplatin used in first line protocol (OR 4.91; 95% CI [1,25-9,69]; p = 0,017) and immune adverse events (OR 10,59; 95% CI [2,30-48,73]; p = 0,002) were significantly associated with a better response rate. The median duration of response for patients treated by chemotherapy (taxanes, methotrexate or platin) after nivolumab was 3 months. Grade 3 or 4 immune adverse events occurred in 8%. Three treatment related deaths were reported: two pneumonitis and one liver graft rejection. Conclusion: Nivolumab is a safety and efficacy treatment for recurrent or metastatic HNSCC after platinum exposure including unfit patients. However, patients in good general conditions seems to have more benefits. Moreover, the onset of immune adverse events seems associated with a better response rate.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03606378
Contributor : Jean-Hugues Morneau Connect in order to contact the contributor
Submitted on : Thursday, March 31, 2022 - 9:06:26 AM
Last modification on : Saturday, April 2, 2022 - 3:34:57 AM

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  • HAL Id : dumas-03606378, version 1

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Sophie Bargas Bouttes. Nivolumab for recurrent or metastatic head and neck carcinoma: a retrospective and prospective real-life study. Human health and pathology. 2021. ⟨dumas-03606378⟩

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