Systemic Treatments for Recurrent or Metastatic Sinonasal Carcinomas: A Retrospective Multicenter Study

INTRODUCTION: Sinonasal cancers are rare and heterogeneous and pose a therapeutic challenge at an advanced stage due to the lack of data on appropriate systemic management. METHODS: This retrospective multicenter study analyzed 83 patients with recurrent or metastatic sinonasal carcinomas ineligible for curative treatment, treated in France between 2012 and 2021 (excluding squamous cell carcinomas and adenoid cystic carcinomas). Data were extracted from the REFCOR (French Network of Expertise on Rare Head and Neck Cancers) and Onco-Occitanie databases, enabling standardized case collection. RESULTS: The main histological subtypes were intestinal-type adenocarcinomas (42.2%), undifferentiated sinonasal carcinomas (19.3%), and olfactory neuroblastomas (14.5%). The predominantly male (85.5%) cohort, with a median age of 60 years at diagnosis, mainly received first-line platinum-based doublet chemotherapy (platinum-etoposide, platinum-5FU). Regardless of histologies and chemotherapy protocols, median overall survival was 13.6 months [10.8; 20.3], with median progression-free survival of 5.3 months [4.4; 6.1]. Complete and partial response rates were 8.3% and 30.6%, respectively, with overall disease control in 73.6% of cases. For adenocarcinomas, platinum-5FU and platinum-taxane regimens were preferred. For sinonasal undifferentiated carcinomas, olfactory neuroblastomas, and neuroendocrine carcinomas, platinum-etoposide was most frequently used. Targeted therapies and immunotherapy were rarely used. CONCLUSION: Improving prognosis requires new strategies, including genomic sequencing and enrollment in clinical trials.