Despite important drug development for HNSCC’s patients (pts) prognostic is still pejorative. HNSCC’s pts don’t routinely benefit of molecular screening (MS) and currently no molecular characteristic lead to driven treatment in their standard of care.
We retrospectively collected data from pts with recurrent or metastatic HSNCC included in MS studies (MATCH R, STING, STARTRK) in Gustave Roussy Cancer Campus between March 2020 and April 2021. MATCH R targeted 161 genes. STING and STRATRK targeted 321 and 324 genes respectively. All results were discussed in molecular tumor board. The aim of the study was to evaluate the impact of MS on early phase trial inclusion.
156 pts were assessed for eligibility and 143 pts were included in the analysis. Mean number alterations observed per patient was 16 (3-41). Targeted molecular alterations that could lead to inclusion in a MS based trial were found in 51 pts, among them 4 (2.8%) were finally included and treated. Median age was 56 years, pts were predominantly male (73.4%) with metastatic disease (64.3%). The first primary tumor site was oral cavity (35%) and 83.3% of pts had received two or more lines of systemic treatment. At the time of analysis 55% of pts had died. Median number of lines before MS was two and the median time between MS and death was 5 month. Most frequent reasons for pts not being included in trials based on their molecular alterations was death before enrollment (25%) and because of specific trial exclusion criteria (21%). Amongst the 4 treated pts, median age was 56 years old and all of the pts were metastatic and had received two lines or more of systemic treatment. 3 of them had laryngeal epidermoid carcinoma. 2 pts are still ongoing treatment within trial with time from start of treatment of 8 month (best response (BR), stable disease) and 1 month (BR not evaluable). 2 pts completed trials with PFS of 10 months (BR partial response) and 2.8 months (BR progressive disease). Patients with MS based treatment, apart from early phase trial, will be also studied.
These results highlight the importance of early molecular screening for pts with recurrence of metastatic HSNCC. Molecular alterations can lead to targeted therapies and significantly improve HSNCC patient’s outcomes.
A. Vozy.
Has not received any funding.
A. Vozy: Non-Financial Interests, Personal, Member: ESMO, ASCO; Financial Interests, Institutional, Research Grant: AstraZeneca, BMS, Boehringer Ingelheim, GSK, INCA, Janssen Cilag, Merck, Pfizer, Roche, Sanofi. A. Bayle: Financial Interests, Personal, Advisory Board: Sanofi. F.R. Ferrand: Financial Interests, Personal, Advisory Board: Merck, Pfizer, Sanofi, MSD. S. Ponce: Financial Interests, Institutional, Research Grant: AstraZeneca, BMS, Boehringer Ingelheim, GSK, INCA, Janssen Cilag, Merck, Pfizer, Roche, Sanofi. Y. Loriot: Financial Interests, Personal, Advisory Board: Merck KGaA, Pfizer, Gilead, Seattle Genetics, Tahio; Financial Interests, Personal, Other, Lectures, Advisory Boards: MSD, AstraZeneca, Astellas, Janssen; Financial Interests, Personal, Other, Lectures, Advisory Boards: Roche, BMS; Financial Interests, Institutional, Research Grant: Janssen, Sanofi, MSD, Roche, Celsius; Financial Interests, Institutional, Invited Speaker: Janssen, Pfizer, Janssen, MSD, Janssen, Exelexis, AstraZeneca, Pfizer, Merck KGaA, BMS, Astellas, Gilead, Incyte; Financial Interests, Personal, Invited Speaker: MSD, Astellas, Gilead/Immunomedics, Basilea, Tahio; Non-Financial Interests, Personal, Member: ESMO, ASCO, AACR; Non-Financial Interests, Personal, Other, scientific committee: ARC. C. Baldini: Financial Interests, Institutional, Advisory Board: BMS; Financial Interests, Institutional, Expert Testimony: MSD; Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Institutional, Research Grant: BMS; Financial Interests, Institutional, Invited Speaker: iTeos, AZ, Janssen, Amgen, Bicycle Therapeutics, MSD, Seattle Genetics, Tahio; Non-Financial Interests, Personal, Member: ASCO, SIOG, SOFOG, AACR. A. Italiano: Financial Interests, Institutional, Research Grant: AstraZeneca, BMS, Boehringer Ingelheim, GSK, INCA, Janssen Cilag, Merck, Pfizer, Roche, Sanofi. C. Even: Financial Interests, Personal, Advisory Board: BMS, MSD, Innate Pharma, Merck Serono; Financial Interests, Institutional, Advisory Board: F Star Therapeutics; Financial Interests, Institutional, Invited Speaker: BMS, AstraZeneca, ISA pharmaceutics, MSD, Debiopharma, Ayala, Novartis. All other authors have declared no conflicts of interest.