Comparison of second-line treatments of recurrent and/or metastatic squamous cell carcinoma of the head and neck

Future Oncol. 2019 Mar;15(8):909-923. doi: 10.2217/fon-2018-0663. Epub 2019 Jan 23.

Abstract

Aim: The literature lacks direct evidence comparing the different regimens evaluated in the second-line treatment of recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN).

Methods: We conducted a network meta-analysis (NMA) of the randomized controlled Phase III trials reporting on the second-line drug treatment options in R/M SCCHN.

Results: The eligible trials included 11 regimens among which six targeted therapies, two immune checkpoint inhibitors and three chemotherapy regimens. Only nivolumab has shown statistically significant superiority over methotrexate in terms of overall survival (HR: 0.64; 95% CI: 0.43-0.96) and objective response rate (OR: 2.51; 95% CI: 1.07-5.86).

Conclusion: Based on the efficacy and safety outcomes of this network meta-analysis, nivolumab seems the most favorable regimen inthe management of R/M SCCHN.

Keywords: metastatic; platinum refractory; recurrent; second line; squamous cell carcinoma of the head and neck.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Clinical Trials, Phase III as Topic
  • Head and Neck Neoplasms / drug therapy*
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology
  • Humans
  • Methotrexate / therapeutic use
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology
  • Network Meta-Analysis
  • Nivolumab / therapeutic use
  • Progression-Free Survival
  • Randomized Controlled Trials as Topic
  • 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
  • Survival Analysis

Substances

  • Nivolumab
  • Methotrexate