Clinical ReportsInduction chemotherapy in nonlaryngeal human papilloma virus-negative high-risk head and neck cancer: a real-world experienceMezi, Silviaa; Pomati, Giuliaa; Botticelli, Andreab; Roberto, Michelab; Cerbelli, Brunaa; Cirillo, Alessioa; Di Gioia, Ciraa; Corsi, Alessandroc; Vullo, Francescoa; De Vincentiis, Marcod; Polimeni, Antonellad; Tombolini, Vincenzoa; Valentini, Valentinod; Marchetti, PaolobAuthor Information Departments of aRadiological, Oncological and Pathological Science bClinical and Molecular Medicine cMolecular Medicine dOdontostomatological and Maxillo-Facial Science, ‘Sapienza’ University of Rome, Italy Received 4 May 2020 Revised form accepted 30 June 2020 Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website, www.anti-cancerdrugs.com. Correspondence to Silvia Mezi, ‘Sapienza’ University of Rome, Viale Regina Elena 324, Rome, Italy, Tel: +39 3356037688; e-mail: [email protected] Anti-Cancer Drugs: November 2020 - Volume 31 - Issue 10 - p 1074-1083 doi: 10.1097/CAD.0000000000000977 Buy SDC Metrics Abstract The role of induction chemotherapy in the multidisciplinary treatment of locally advanced, nonlaryngeal high-risk human papilloma virus (HPV)-negative head and neck squamous cells carcinoma (HNSCC) is uncertain in terms of overall survival (OS). The primary objective of this study was to identify possible predictive factors of survival and outcome in patients with HNSCC who were treated with induction chemotherapy. Fifty-nine patients with stage IVa/b HPV-negative non-laryngeal HNSCC (mostly originating from the oral cavity) who underwent induction chemotherapy at Policlinico Umberto I were reviewed. Treatment outcomes in term of objective response rate (ORR), progression-free survival (PFS), OS and toxicities were analyzed. A significant association between nodal status, ORR, ongoing smoking use, toxicities and OS was demonstrated. ORR (obtained in 61% of patients) was associated with a reduction in mortality of 80% (P< 0.0001). Early discontinuation after just one cycle of induction chemotherapy was associated to a significantly shorter OS. In oral cavity radical surgery with negative margins was obtained in 15/16 patients. In 42% of patients G3-G4 toxicity occurred. Toxicity requiring hospitalization occurred in 42% and 21% of patients with oropharyngeal and oral cavity carcinoma, respectively. Five patients died of treatment-related causes. No treatment-related mortality occurred in oral cavity patients. G5 toxicities were different according to the sub-sites of disease (P = 0.05). Induction chemotherapy in non-laryngeal high-risk HNSCC is an active strategy, most importantly in oral cavity cancer, even though burdened with a high (G ≥ 3) toxicity and early discontinuation rate. These data will however need to be confirmed in further and larger studies. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.