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Efficacy of first-line systemic treatment regimens for recurrent/metastatic head and neck squamous cell carcinoma: a network meta-analysis

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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the efficacy on overall survival (OS) and progression-free survival (PFS) of the first-line systemic therapy regimens on 6-, 12-, 18-, 24-, and 30 months in recurrent/metastatic head and neck squamous cell carcinoma (R/M-HNSCC) and figure out the best regimen.

Methods

PubMed, Embase, The Cochrane Library, Scopus, and Google Scholars were systematically searched for studies in regard to the first-line systemic regimens for R/M-HNSCC from inception to March 2022. Odds ratios (ORs) were generated for dichotomous variants by network meta-analysis. The primary endpoint was OS, and the second endpoint was PFS. The software implemented was STATA 17.0 MP.

Results

Eventually, 18 studies with 5298 patients and 12 first-line systematic regimens were enrolled. immunotherapy + chemotherapy (OR = 2.30, 95% CI 1.60–3.31) and single immunotherapy (OR = 1.91, 95% CI 1.33–2.76) were significantly superior to the EXTREME on OS at 30th month. Meantime, immunotherapy + chemotherapy (SUCRA = 87.7%) has the highest ranking. TPEx (OR = 1.61, 95% CI 1.05–2.48) showed significantly better efficacy compared with EXTREME on PFS at 12th month. Simultaneously, TPEx (SUCRA = 87.1%) had the highest ranking and was the long-lasting first-echelon regimen both in OS and PFS from a longitudinal perspective. It should be noted that EXTREME included platinum-based chemotherapy + fluorouracil + cetuximab, TPEx included docetaxel + cisplatin + cetuximab.

Conclusion

Considering the efficacy, safety, compliance, and economic profiles collectively, one of the standard first-line regimens, literally TPEx should be recommended as the best choice for R/M-HNSCC. Furthermore, more head-to-head trials are needed to confirm those findings.

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Graduate School, Hebei North University, Zhangjiakou, 075000, China

    Xiao Yu

  2. Otorhinolaryngology Head and Neck Surgery, Air Force Medical Center, Beijing, 100142, China

    Xiao Yu, Xiaolei Su, Ling Fang, Honglei Zhang, Yu Pu, Hongyi Liu & Rui Guo

  3. School of Health, Brooks College (Sunnyvale), Sunnyvale, USA

    Xi Chen

  4. Department of Epidemiology and Statistics, School of Public Health, Medical College, Zhejiang University, Hangzhou, China

    Xi Chen

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  1. Xiao Yu
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Correspondence to Rui Guo.

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Yu, X., Su, X., Fang, L. et al. Efficacy of first-line systemic treatment regimens for recurrent/metastatic head and neck squamous cell carcinoma: a network meta-analysis. Eur Arch Otorhinolaryngol 280, 1391–1401 (2023). https://doi.org/10.1007/s00405-022-07673-4

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