Metastasis-directed therapy may reduce risk of death in HNSCC

Metastasis-directed therapy (MDT) may confer significant benefit to patients with head and neck squamous cell carcinoma (HNSCC) with limited metastatic disease, suggests a recent study.

Of the 186 patients analysed, 30 (16.1 percent) underwent MDT. Five-year overall survival (OS) was higher among patients with a single metastasis (35 percent, 95 percent CI, 16–54 percent) than among those with multiple metastases (4 percent, 2–9 percent).

Multivariable analysis revealed that oral cavity (hazard ratio [HR], 2.22, 1.16–4.25; p=0.015) or sinonasal primary (HR, 4.88, 1.10–21.70; p=0.037) were associated with a higher risk of death. In contrast, treatment with MDT (HR, 0.36, 0.17–0.74; p=0.006) was associated with a lower risk of death.

Following MDT, median subsequent metastasis-free survival was estimated at 26.4 months (9.8–54.0 months) and 5-year survival was 31 percent (15–48 percent).

This study examined the outcomes of metastatic HNSCC by disease burden with an emphasis on MDT in patients with limited metastatic disease burden. A total of 186 patients who developed metastatic disease after definitive therapy for HNSCC were included.

The authors enumerated clinically and radiographically apparent metastases. They used Kaplan-Meier methods to estimate survival and Cox regression to evaluate the association between clinical variables.

“Prospective trials evaluating MDT in HNSCC are warranted,” the authors said.

Following first-line best systemic treatment, median survival for recurrent/metastatic HNSCC patients is around 10 months. [Future Oncol 2018;14:877-889]