Impact of Prior Immune Checkpoint Inhibitor Treatment on the Efficacy of Weekly Paclitaxel and Cetuximab in Recurrent or Metastatic Head and Neck Cancer

AIM: The optimal treatment sequence involving immune checkpoint inhibitors (ICIs) and chemotherapy for recurrent or metastatic head and neck cancer remains unclear. This study aimed to evaluate the efficacy of weekly paclitaxel and cetuximab (PTX + Cmab) following prior ICI treatment. METHODS: We retrospectively analyzed 52 patients with unresectable recurrent or metastatic head and neck cancer who received PTX + Cmab. Patients were divided into two groups according to prior ICI treatment status. Treatment outcomes, including overall response rate (ORR), progression-free survival (PFS), and overall survival (OS), were compared. RESULTS: The ORR was 42.2%. Patients with prior ICI treatment showed a significantly higher ORR compared to those without prior ICI treatment (61.5% vs. 15.8%, p = 0.003). PFS was significantly longer in patients with prior ICI treatment (median, 5.4 vs. 4.4 months, p = 0.04). OS did not differ significantly between the groups (median, 15.1 vs. 11.0 months). CONCLUSION: PTX + Cmab was associated with a higher response rate and longer PFS in patients with prior ICI treatment. These findings suggest a clinical association between prior ICI treatment and improved response to subsequent PTX + Cmab.