PEMBROLIZUMAB THERAPY AS FIRST-LINE TREATMENT FOR RECURRENT OR METASTATIC HEAD AND NECK SQUAMOUS CELL CARCINOMA AT HO CHI MINH CITY ONCOLOGY HOSPITAL
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Abstract
Background: Pembrolizumab, a PD-1 immune checkpoint inhibitor, has been approved as a first-line treatment for patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC), demonstrating improved overall survival. Recently, real data from Vietnam on the use of these regimes remains limited.
Objective: To evaluate overall response rates (ORR), time on treatment (ToT), and toxicities among individuals receiving first-line pembrolizumab therapy for recurrent or metastatic HNSCC at Ho Chi Minh City Oncology Hospital.
Methods: We conducted a retrospective case series at Ho Chi Minh City Oncology Hospital. A total of 24 patients with recurrent/metastatic HNSCC were treated with at least two cycles of first-line pembrolizumab-containing regimens (monotherapy when CPS≥1 or in combination with chemotherapy) between August 2023 and May 2025.
Results: Most patients were male, smoking (2/3 cases), with a mean age of 56,1 years (up to 88 years). ECOG performance status 2 was observed in 16,7%. PD-L1 testing was performed in 79,2% of cases, of whom 70,9% had CPS ≥1. The figure for patients with stage IVc was 16,7% at initial diagnosis. Regarding treatment patterns, a patient received pembrolizumab alone, and 23 individuals received pembrolizumab plus chemotherapy, of which 39,1% were treated with cisplatin-based doublets. The overall response rate was 47%. Median time on treatment was 7 months (95% CI: 5,1–8,9). Notable toxicities included grade 3 neutropenia (8,3%) and grade 2 anemia (4,2%), grade 1–2 nausea/vomiting, and hepatitis occurring in 12.5% each. One case of grade 3 renal impairment, and one case of grade 1 thyroiditis.
Conclusions: These results represent preliminary data on the effectiveness of first-line pembrolizumab therapy for recurrent/metastatic HNSCC. However, further research with a larger sample size and longer follow-up is needed to support the efficacy and safety of immune regimes in real-world settings.
Keywords
Head and neck squamous cell carcinoma, recurrent/metastatic, immunotherapy
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References
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