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Article: Systemic Therapy in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma- A Systematic Review and Meta-Analysis
Title | Systemic Therapy in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma- A Systematic Review and Meta-Analysis |
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Authors | |
Keywords | Head and Neck Neoplasms/therapy Neoplasm Recurrence Local/therapy Neoplasms Metastasis Immunotherapy |
Issue Date | 2020 |
Publisher | Elsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/critrevonc |
Citation | Critical Reviews in Oncology/Hematology, 2020, v. 153, p. article no. 102984 How to Cite? |
Abstract | Background:
The most effective regimen is unclear for patients with recurrent or metastatic head and neck squamous cell carcinomas (R/M HNSCC). We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating only systemic therapy for R/M HNSCC.
Methods:
This systematic review followed PRISMA and the Cochrane Collaboration Handbook for Systematic Reviews of Interventions. Endpoints included overall survival (OS), progression-free survival (PFS) and overall response rates (ORR).
Results:
55 RCTs from 1990-November 2019 qualified for review (n=12132). Only PD-1/PDL-1 inhibitors increased OS in R/M HNSCC platinum-resistant disease against their control (HR = 0·79, 95%CI 0·70-0.90, p<0·001), especially for PD-L1 ≥ 1% expressing tumours (HR = 0·72, 95%CI 0·60-0·86, p<0·001). PFS was prolonged for anti-EGFR agents against methotrexate when used in a second line setting (HR = 0·74, 95 %CI 0·62-0·87, p=0·001), and when cetuximab (HR = 0·60, 95%CI 0·49-0·72, p<0·0001) and panitumumab (HR = 0·76, 95%CI 0·65-0·89, p=0·001) were introduced to platinum-based regimens for first-line treatment.
Conclusions:
PD-1/PD-L1 inhibitors may represent the future of R/M HNSCC treatment. However, EGFR inhibitors may still play improve clinical outcomes. |
Description | Hybrid open access |
Persistent Identifier | http://hdl.handle.net/10722/301926 |
ISSN | 2021 Impact Factor: 6.625 2020 SCImago Journal Rankings: 2.084 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Lau, A | - |
dc.contributor.author | Yang, WF | - |
dc.contributor.author | L, KY | - |
dc.contributor.author | Su, YX | - |
dc.date.accessioned | 2021-08-21T03:29:01Z | - |
dc.date.available | 2021-08-21T03:29:01Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Critical Reviews in Oncology/Hematology, 2020, v. 153, p. article no. 102984 | - |
dc.identifier.issn | 1040-8428 | - |
dc.identifier.uri | http://hdl.handle.net/10722/301926 | - |
dc.description | Hybrid open access | - |
dc.description.abstract | Background: The most effective regimen is unclear for patients with recurrent or metastatic head and neck squamous cell carcinomas (R/M HNSCC). We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating only systemic therapy for R/M HNSCC. Methods: This systematic review followed PRISMA and the Cochrane Collaboration Handbook for Systematic Reviews of Interventions. Endpoints included overall survival (OS), progression-free survival (PFS) and overall response rates (ORR). Results: 55 RCTs from 1990-November 2019 qualified for review (n=12132). Only PD-1/PDL-1 inhibitors increased OS in R/M HNSCC platinum-resistant disease against their control (HR = 0·79, 95%CI 0·70-0.90, p<0·001), especially for PD-L1 ≥ 1% expressing tumours (HR = 0·72, 95%CI 0·60-0·86, p<0·001). PFS was prolonged for anti-EGFR agents against methotrexate when used in a second line setting (HR = 0·74, 95 %CI 0·62-0·87, p=0·001), and when cetuximab (HR = 0·60, 95%CI 0·49-0·72, p<0·0001) and panitumumab (HR = 0·76, 95%CI 0·65-0·89, p=0·001) were introduced to platinum-based regimens for first-line treatment. Conclusions: PD-1/PD-L1 inhibitors may represent the future of R/M HNSCC treatment. However, EGFR inhibitors may still play improve clinical outcomes. | - |
dc.language | eng | - |
dc.publisher | Elsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/critrevonc | - |
dc.relation.ispartof | Critical Reviews in Oncology/Hematology | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Head and Neck Neoplasms/therapy | - |
dc.subject | Neoplasm Recurrence | - |
dc.subject | Local/therapy | - |
dc.subject | Neoplasms Metastasis | - |
dc.subject | Immunotherapy | - |
dc.title | Systemic Therapy in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma- A Systematic Review and Meta-Analysis | - |
dc.type | Article | - |
dc.identifier.email | Yang, WF: teddyrun@hku.hk | - |
dc.identifier.email | Su, YX: richsu@hku.hk | - |
dc.identifier.authority | Yang, WF=rp02768 | - |
dc.identifier.authority | Su, YX=rp01916 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1016/j.critrevonc.2020.102984 | - |
dc.identifier.pmid | 32569853 | - |
dc.identifier.scopus | eid_2-s2.0-85086664579 | - |
dc.identifier.hkuros | 324279 | - |
dc.identifier.volume | 153 | - |
dc.identifier.spage | article no. 102984 | - |
dc.identifier.epage | article no. 102984 | - |
dc.identifier.isi | WOS:000571802900009 | - |
dc.publisher.place | Ireland | - |