Efficacy of second and subsequent lines of chemotherapy for recurrent and metastatic head and neck cancer

Auris Nasus Larynx. 2021 Feb;48(1):161-165. doi: 10.1016/j.anl.2020.07.016. Epub 2020 Aug 3.


Objective: The increase in treatment options resulted in successful treatment with multiple lines of chemotherapy for recurrent and metastatic (RM) head and neck cancer (HNC). The present study aimed to elucidate the beneficial effect of successive treatment for RM-HNC.

Methods: We included 78 patients with RM-HNC who received one or multiple lines of chemotherapy from January 2008 to December 2019. We divided the patients into three groups according to treatment period: January 2008 to November 2012 included those who underwent cancer chemotherapy only with cytotoxic agents (Tox group), December 2012 to March 2017 included those who received cytotoxic agents and cetuximab (Cet group), and March 2017 to December 2019 included those who received cytotoxic agents, cetuximab and immune checkpoint inhibitor nivolumab (Nivo group). Moreover, we compared the overall survival of the three groups.

Results: In total, 18, 33, and 27 patients were included in the Tox, Cet, and Nivo groups, respectively. The median overall survival were 8.5 months in the Tox group, 16 months in the Cet group, and 19 months in the Nivo group, and the difference in the result was significant.

Conclusions: Successive treatment with second and subsequent lines of chemotherapy in patients with RM-HNC improves prognosis.

Keywords: Chemotherapy; Head and neck cancer; Recurrent and metastatic; Second-line; Successive.

Publication types

  • Clinical Study
  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Immunological / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cetuximab / administration & dosage*
  • Female
  • Head and Neck Neoplasms / drug therapy*
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology
  • Humans
  • Immune Checkpoint Inhibitors / administration & dosage
  • Male
  • Middle Aged
  • Neoplasm Metastasis / drug therapy
  • Neoplasm Recurrence, Local / drug therapy
  • Nivolumab / administration & dosage*
  • Prognosis
  • Survival Rate


  • Antineoplastic Agents, Immunological
  • Immune Checkpoint Inhibitors
  • Nivolumab
  • Cetuximab