NOTE

🌱 created from: head_and_neck_squamous_cell_cancer

palliative_intent-of-hnscc

• For distant mets or recurrent dz s/p RT that is unresectable or ineligible for more RT
• 1st-line preferred:
  • Platinum-doublet (CIS/carbo + 5-FU) with pembrolizumab or pembrolizumab monotherapy in PD-L1 (+) tumors with CPS ≥1. Both regimens demonstrated OS advantage over EXTREME; no PFS advantage (KEYNOTE-048, Lancet 2019;349;1915)
• Historically & alternatively:
  • EXTREME (CIS/carbo + 5-FU with cetuximab) was the 1st-line regimen due to improved efficacy with addition of cetuximab to platinum doublet (EXTREME, NEJM 2008;359:1116)
  • also look at TPExtreme
• Cetuximab tox:
  • Acneiform rash (correlates w/ response), GI complaints, hypersensitivity rxn
• 2nd-line (if not previously used): Nivolumab & pembrolizumab following progression on or after platinum therapy
  • CheckMate 141
  • lux-hn
  • keynote-040