Clinical outcomes and prognostic factors in recurrent and/or metastatic head and neck cancer patients treated with chemotherapy plus cetuximab as first-line therapy in a real-world setting

Roberta Depenni, Maria Cossu Rocca, Daris Ferrari, Giuseppe Azzarello, Cinzia Baldessari, Massimiliano Alù, Franco Nolé, Carla Codecà, Giorgia Boscolo, Marco Piccininni, Stefano Cavalieri, Paolo Bossi

Research output: Contribution to journalArticle


Aim: The aims of the study are to evaluate the clinical outcomes of first-line treatment with platinum-based chemotherapy and cetuximab in patients with relapsing/metastatic head and neck cancer (RM HNC) and to identify predictors of treatment response. Methods: This is a retrospective, observational, longitudinal, real-world study involving 6 oncology centres in Italy. All consecutive patients with RM HNC treated between January 2007 and December 2016 with a first-line therapy consisting of a platinum-based chemotherapy regimen plus cetuximab were included. The primary objective of the study was to assess overall survival (OS) and progression-free survival (PFS). Secondary objectives included the identification of predictors of treatment response. Results: Overall, 297 patients were identified. Median OS was 10.8 months (95% confidence interval [CI] 9.3–12.2), whereas median PFS was 4.8 months (95% CI 4.3–5.5). On multivariable analysis, independent unfavourable prognostic factors for OS were performance status (PS) Eastern Cooperative Oncology Group (ECOG) >0, presence of residual tumour at primary site, platinum resistance and lack of objective response. Unfavourable predictors for PFS included cancer primary site (paranasal sinuses, hypopharynx), PS ECOG >0, presence of residual tumour at primary site, platinum resistance and lack of objective response. Independent unfavourable predictors of objective response were tumour site (oral cavity, larynx-hypopharynx), residual tumour at primary site and prior chemotherapy. Conclusions: The availability of new treatment modalities and epidemiological changes make the periodic reassessment of prognostic factors of great relevance to guide clinical practice and the design of future randomised clinical trials.

Original languageEnglish
Pages (from-to)4-12
Number of pages9
JournalEuropean Journal of Cancer
Publication statusPublished - Jul 2019



  • Cetuximab
  • Head and neck cancer
  • Platinum-based chemotherapy
  • Prognostic factors
  • Relapsing/metastatic disease

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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