Abstract P101: Combined metronomic chemo-immunotherapy in head and neck cancers: An experience from the developing and resource poor country

Abstract

Abstract Background: Head and Neck squamous cell carcinomas (HNSCC) have proven to be inherently resistant to systemic treatments; with limited treatment option after progression on systemic chemotherapy in HNSCCs Immunotherapy has a role to play with improved results. Methods: All 7 patients with advanced, metastatic-HNSCCs, received Inj. Nivolumab 240mg flat dose or 3mg per kg, intravenously every 2 weekly along with low dose capecitabine 500mg twice a day, were prospectively assessed. Patient’s clinical, hematological and staging characteristics were described and Clinical Benefit Rate (CBR) was calculated. Results: Total 7 patients received the combined metronomic chemo-immunotherapy (CMCI). Majority of patients were belonging to ECOG-PS 1(66%), with all patients being in stage IV disease. Three, three &one patient received Immunotherapy as 5th, 3rd and 4th line of therapy respectively. Nivolumab and low dose Capecitabine was used in all 7 patients. CBR was seen in 71.42% (5/7) patients, one patient died due hepatitis and hepatic encephalopathy, and one patient was having progressive disease, and one patient with stable disease discontinued of treatment because of financial constraints and kept on capecitabine alone. Majority tolerated therapy well with no grade 3/4 Immune related adverse events (IRAEs). One patient required supportive therapy with packed red cell transfusion and Albumin infusions. Conclusions: To conclude nivolumab along with metronomic chemotherapy with low dose capecitabine was very well tolerated and exhibited antitumor activity with CBR of 71% in extensively pretreated patients with HNSCCs. Additional studies of Nivolumab and metronomic chemotherapy and immuno-immuno combination therapy in these diseases are ongoing. Citation Format: Irappa Madabhavi, Malay Sarkar, Pham Nguyen Quy, Apurva Patel. Combined metronomic chemo-immunotherapy in head and neck cancers: An experience from the developing and resource poor country [abstract]. In: Proceedings of the AACR-NCI-EORTC Virtual International Conference on Molecular Targets and Cancer Therapeutics; 2021 Oct 7-10. Philadelphia (PA): AACR; Mol Cancer Ther 2021;20(12 Suppl):Abstract nr P101.