1114PDHigh immunoscore is associated with good response to neo-adjuvant chemotherapy and prolonged survival in advanced head and neck cancer patients

AbstractBackgroundThe presence of high levels of tumor immune infiltrate has been recognized to be associated with better prognosis in Head and Neck cancer (H&N). The consensus Immunoscore quantifies the densities of CD3 and CD8 in the center of the tumour (CT) and the invasive margin (IM) and stratifies patients into 3 Immunoscore categories (Low, Intermediate and High). Table: 1115PDCutpointSensitivitySpecificityN (prevalence)ORR, %Odds Ratio (CI)PFS HR (CI)OS HR (CI)TPS ≥50%0.470.7765 (0.27)26.23.83 (1.31, 11.15)0.59 (0.40, 0.87)0.54 (0.36, 0.82)TPS ≥20%0.560.6494 (0.39)21.31.84 (0.83, 4.11)0.72 (0.52, 0.99)0.66 (0.47, 0.93)TPS ≥1%0.640.44140 (0.57)16.41.56 (0.79, 3.10)0.95 (0.74, 1.22)0.75 (0.57, 0.97)CPS ≥500.500.7864 (0.26)28.14.70 (1.62, 13.59)0.60 (0.4 1, 0.89)0.60 (0.40, 0.91)CPS ≥200.580.6496 (0.39)21.92.42 (1.10, 5.33)0.75 (0.55, 1.01)0.63 (0.46, 0.86)CPS ≥10.940.23195 (0.80)17.41.85 (1.01, 3.37)0.89 (0.72, 1.11)0.72 (0.58, 0.91)All1.000.00244 (1.00)14.81.43 (0.83, 2.46)0.94 (0.77, 1.14)0.79 (0.65, 0.97)CPS, combined positive score; HR, haz ard ratio; ORR, objective response rate; OS, overall survival; PFS, progression-free survival; SOC, standard of care; TPS, tumor proportion score.Sensitivity, specificity, N (prevalence), and ORR are for the pembrolizumab arm. Odds ratio, PFS HR, and OS HR compare pembrolizumab and SOC.MethodsThis retrospective ongoing study evaluated the Immunoscore in 110 patients with advanced laryngeal (n  = 5...
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research

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ConclusionsA single-cycle induction chemotherapy for HNSCC enables surgery plus adjuvant therapy as well as chemoradiotherapy. The long-term local and distant disease control was good but varied between tumors in the larynx and mesopharynx/tongue vs. hypopharynx.
Source: European Archives of Oto-Rhino-Laryngology - Category: ENT & OMF Source Type: research
ConclusionsThese preliminary results suggest a promising response to single cycle induction treatment with cisplatin/ docetaxel plus durvalumab/ tremelimumab in unselected HNSCC patients. Furthermore, they show an induction of an immune response in both in the tumor tissue and the peripheral blood.Clinical trial identificationNCT03426657.Legal entity responsible for the studyThe authors.FundingAstraZeneca.DisclosureM. Hecht: Research grant / Funding (institution): AstraZeneca; Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: MSD. A. Gostian: Advisory / Consultancy: test. M....
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
Conclusions: HART represents an attractive approach for patients with HNSCC where treatment intensification is indicated. PMID: 31519130 [PubMed - as supplied by publisher]
Source: Acta Oncologica - Category: Cancer & Oncology Authors: Tags: Acta Oncol Source Type: research
CONCLUSIONS: Definitive carboplatin-based chemoRT was equivalent to cisplatin-based therapy and superior to RT alone and RT with concurrent cetuximab. In light of recent results of the RTOG 1016 and De-ESCALaTE trials, our findings suggest that carboplatin-based regimens warrant prospective investigation as an alternative to cisplatin for patients who are not cisplatin candidates. PMID: 31487677 [PubMed - in process]
Source: Journal of the National Comprehensive Cancer Network : JNCCN - Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research
Nature Reviews Clinical Oncology, Published online: 12 June 2019; doi:10.1038/s41571-019-0227-zThe authors of this Review discuss treatments currently available for patients with head and neck squamous cell carcinomas (focusing in those of the oral cavity, oropharynx, hypopharynx and larynx). Advances in surgical and non-surgical approaches (mainly combinations of radiotherapy and chemotherapy) are discussed, including the first immunotherapeutic agents approved for these malignancies.
Source: Nature Reviews Clinical Oncology - Category: Cancer & Oncology Authors: Source Type: research
Conclusions In the span of a very short time—less than a decade—robotic head and neck surgery has transformed the management of the head and neck cancer, and it seems clear that the future of treatment for these cancers lies in a multimodal approach in which TORS is likely to play an important role. Nevertheless, it is important to keep in mind that the current indications for TORS are limited and long-term data on the safety and oncological outcomes are needed to better understand the true role of TORS in treatment of head and neck cancer. Nonetheless, the emergence of ever more advanced robotic instruments i...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Patients with cancers of the head and neck are more likely to have an increased prevalence of mental health disorders after their cancer is diagnosed compared with the general population, according to areport published today inJAMA Otolaryngology-Head and Neck Surgery.There appears to be an especially strong association between mental health disorders and cancers of the trachea. Additionally, patients who received multimodal therapy —radiotherapy, chemotherapy, and/or surgery—have a higher risk of developing mental health disorders compared with those who receive only surgery, according to the report.“Hig...
Source: Psychiatr News - Category: Psychiatry Tags: head and neck cancers JAMA Otolaryngology –Head & Neck Surgery mental health disorders Source Type: research
Conclusion: Our results suggest that induction chemotherapy improves numerous aspects of swallowing and has a positive impact on the quality of life of pre-chemoradiotherapy patients. PMID: 30678386 [PubMed - in process]
Source: Asian Pacific Journal of Cancer Prevention - Category: Cancer & Oncology Tags: Asian Pac J Cancer Prev Source Type: research
AbstractFunctional organ preservation is a major challenge in management of advanced laryngeal and hypopharyngeal carcinoma. Although ideal approach is a subject of much debate, radiotherapy with or without chemotherapy is most commonly used modality. This randomized study was conducted to compare functional organ preservation by chemoradiation (CRT) versus concomitant boost radiotherapy (CBRT). A total of 40 patients with advanced (stage III/stage IVa) laryngeal and hypopharyngeal cancer were randomized to receive either CRT (n  = 20) to a dose of 66 Gy in 33 fractions over 6.5 weeks with concurren...
Source: Indian Journal of Otolaryngology and Head and Neck Surgery - Category: ENT & OMF Source Type: research
Conditions:   Stage II-IVB Operable HNSCC Oral Cavity;   Hypopharynx;   Oropharynx;   Larynx Interventions:   Drug: Durvalumab;   Drug: durvalumab + tremelimumab Sponsor:   Yonsei University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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