Treatment of Recurrent or Metastatic Hypopharyngeal Squamous Cell Carcinoma with PD-L1-Negative Tumour
This protocol applies to patients with recurrent or metastatic hypopharyngeal squamous cell carcinoma whose disease is no longer amenable to curative radiotherapy or surgery, and who have not received platinum-based chemotherapy within the preceding 6 months.
Tumour PD-L1 expression status is the pivotal biomarker driving treatment selection in this setting. Patients with PD-L1-negative disease represent a distinct subgroup for which different evidence-based regimens apply compared to PD-L1-expressing tumours.
In this first-line setting, the established standard involves a platinum-based combination that includes a targeted antibody — a regimen supported at the highest level of clinical evidence for recurrent/metastatic disease not expressing PD-L1. The complete protocol details the full regimen selection, eligibility assessment, and management of patients with contraindications to standard therapy.
References
DOI: 10.1016/j.annonc.2020.07.011- No platinum-based ChT during the last 6 months and PD-L1-negative tumour
- Platinum/5-FU/cetuximab remains the standard therapy for recurrent/metastatic patients with SCCHN not expressing PD-L1 [I, A; ESMO-MCBS v1.1 score: 3].
- Platinum/5-FU/cetuximab [I, A; MCBS 3]
- In the first-line treatment of recurrent SCCHN, EXTREME is standard of care for patients with contraindications to anti-PD-1 inhibitors [I, A] and in patients with a tumour not expressing PD-L1 [II, B].