The following is a summary of “A Systematic Review of antibody-drug Conjugates and Bispecific Antibodies in Head and Neck Squamous Cell Carcinoma and nasopharyngeal carcinoma: Charting the Course of Future Therapies,” published in the May 2024 issue of Oncology by Jiménez-Labaig et al.
Head and neck squamous cell carcinoma (HNSCC) and nasopharyngeal carcinoma (NPC) present ongoing challenges, particularly in the recurrent and metastatic (R/M) stages, necessitating improved treatment outcomes. Antibody-drug conjugates (ADC) and bispecific antibodies (BsAb) have emerged as promising therapeutic approaches.
A comprehensive systematic review was conducted to identify clinical trials investigating ADCs and BsAbs in patients with HNSCC and NPC, spanning from database inception to December 2023. Key outcomes included trial characteristics, overall response rate (ORR), overall survival (OS), and grade ≥ 3 treatment-related adverse events (trAEs).
The review encompassed 23 trials, predominantly phase I studies, involving 540 patients with R/M disease (355 in HNSCC and 185 in NPC). Of these, 13 trials evaluated ADCs (n = 343 patients), and 10 assessed BsAbs (n = 197 patients). Approximately 96% of patients had previously failed standard treatments. ORR varied widely, with notable responses such as GEN1042 combined with chemoimmunotherapy. Monotherapy ORRs were 47% for ADCs and 0–37% for BsAbs. MRG003 achieved ORRs of 43% in HNSCC and 47% in NPC, while BL-B01D1 reached 54% in NPC. Median OS was most prolonged with MRG003 and KN046. Grade ≥ 3 trAEs were reported in 28–60% of ADC trials and 3–33 % of BsAb trials, predominantly myelosuppressive trAEs in ADCs and infusion-related reactions in BsAbs. Four treatment-related deaths occurred, including one case of pneumonitis, all in ADC trials.
ADCs and BsAbs demonstrate considerable potential in treating R/M HNSCC and NPC. However, findings are limited by small sample sizes, absence of control arms, and notable adverse events, such as myelosuppression with ADCs and infusion-related reactions with BsAbs. Further rigorous investigation is essential to establish their efficacy and safety profiles in these challenging patient populations.
Source: sciencedirect.com/science/article/abs/pii/S0305737224001002
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