Paclitaxel-Ifosfamide-based Therapy as Salvage Treatment in Platinum-resistant Recurrent/Metastatic Head and Neck Cancer

• Published in: In vivo (Athens) Vol. 38; no. 4; pp. 1891 - 1899
• Main Authors: CHOU, MING-YU, WU, WEN-CHI, CHU, PEN-YUAN, TAI, SHYH-KUAN, CHANG, PETER MU-HSIN, LEE, TSUNG-LUN, CHEN, TIEN-HUA, YANG, MUH-HWA
• Format: Journal Article
• Language: English
• Published: Greece International Institute of Anticancer Research 01.07.2024
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer therapies; Chemotherapy; Drug Resistance, Neoplasm; Female; Head and Neck Neoplasms - drug therapy; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - pathology; Humans; Ifosfamide - administration & dosage; Ifosfamide - therapeutic use; Immunotherapy; Larynx; Magnetic resonance imaging; Male; Medical prognosis; Metastasis; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - pathology; Oncology; Paclitaxel - administration & dosage; Paclitaxel - therapeutic use; Patients; Platinum - therapeutic use; Retrospective Studies; Salvage Therapy; Squamous Cell Carcinoma of Head and Neck - drug therapy; Squamous Cell Carcinoma of Head and Neck - mortality; Squamous Cell Carcinoma of Head and Neck - pathology; Surgery; Treatment Outcome; paclitaxel; ifosfamide; metastatic; cetuximab; Resistant; immune checkpoint inhibitors; platinum-resistant; head and neck squamous cell carcinoma
• ISSN: 0258-851X; 1791-7549; 1791-7549
• DOI: 10.21873/invivo.13644

Treatment options are limited, and the prognosis is poor for patients with platinum-resistant recurrent metastatic (R/M) head and neck squamous cell carcinoma (HNSCC). This study evaluated the efficacy and safety of a paclitaxel and ifosfamide (TI) regimen in patients with R/M HNSCC whose disease had progressed following platinum-based therapy. In this retrospective study, we included 53 patients with R/M HNSCC who underwent at least one cycle of TI-based therapy, post platinum failure, between February 2020 and August 2023. Some patients received the TI regimen in combination with immunotherapy and/or cetuximab. Key metrics assessed included the objective response rate (ORR), disease control rate, and progression-free as well as overall survival. The study observed an ORR of 15.8% and a disease control rate of 36.8%. The median progression-free survival for the entire cohort was 3.3 months, and the median overall survival was 9.6 months. Notably, the combination of TI with immunotherapy yielded a higher ORR of 30.8%, compared to 14.3% with TI alone. The most prevalent grade 1-2 adverse events were anemia (81%), weight loss (68%) and hypernatremia (55%). The TI-based regimen demonstrated favorable efficacy and safety profile in treating R/M HNSCC. Enhanced outcomes may be attainable when combining it with immunotherapy. This study suggests that TI-based therapy could serve as a potential salvage option for this specific patient group.