{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T11:00:06Z","timestamp":1785150006674,"version":"3.55.0"},"reference-count":14,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Cetuximab-based therapies continue to play an important role in the management of recurrent\/metastatic head and neck squamous cell carcinoma (R\/M HNSCC) despite the increasing use of immunotherapy. However, data regarding treatment outcomes and prognostic factors remain limited. This study aimed to evaluate treatment outcomes and prognostic factors associated with survival in patients with R\/M HNSCC treated with cetuximab-based regimens. Methods: This retrospective single-center cohort study included patients with recurrent\/metastatic HNSCC who received cetuximab-based systemic therapy at the Department of Medical Oncology, Manisa Celal Bayar University Faculty of Medicine, between May 2012 and September 2025. Demographic, clinical, laboratory, and PET\/CT data were retrospectively analyzed. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan\u2013Meier method and compared using the log-rank test. Prognostic factors associated with survival were evaluated using univariable and multivariable Cox proportional hazards regression analyses. Results: A total of 57 patients were included in the study. The median age was 65 years, and 91.2% of patients were male. Most patients had ECOG performance status 0\u20131 (94.7%) and stage IV disease (71.9%). The larynx was the most common primary tumor site (50.9%), while distant lymph node metastasis (63.2%) and lung metastasis (61.4%) were the predominant metastatic sites. Median PFS and OS were 4.6 months and 13.8 months, respectively. Kaplan\u2013Meier analysis demonstrated that patients with a body mass index (BMI) &gt; 25 had longer OS, whereas chronic kidney disease (CKD), primary tumor localization, and best response to first-line treatment were significantly associated with survival. In multivariable Cox regression analysis, chronic kidney disease (CKD) (HR: 5.15, p = 0.004), oral cavity primary tumor localization (HR: 2.55, p = 0.013), progressive disease as the best response to first-line treatment (HR: 4.44, p &lt; 0.001) and the absence of grade 1\u20132 cetuximab-related dermatologic toxicity (HR: 3.20, p = 0.027) remained independent adverse prognostic factors. BMI was not independently associated with survival in multivariable analysis. Conclusions: Cetuximab-based therapy demonstrated clinically meaningful activity in patients with R\/M HNSCC. Comorbidities, primary tumor localization, the absence of grade 1\u20132 cetuximab-related dermatologic toxicity and treatment response appear to substantially influence survival outcomes. Larger prospective studies are warranted to validate these findings.<\/jats:p>","DOI":"10.3390\/jcm15155852","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T09:47:41Z","timestamp":1785145661000},"page":"5852","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes and Prognostic Factors of Cetuximab-Based Therapy in Recurrent\/Metastatic Head and Neck Squamous Cell Carcinoma"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9825-1152","authenticated-orcid":false,"given":"Melike","family":"D\u00f6nmez Tekin","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Manisa Celal Bayar University, Manisa 45030, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4859-7574","authenticated-orcid":false,"given":"Atike P\u0131nar","family":"Erdo\u011fan","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Manisa Celal Bayar University, Manisa 45030, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1857-593X","authenticated-orcid":false,"given":"Mustafa","family":"\u015eahbazlar","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Manisa Celal Bayar University, Manisa 45030, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9317-942X","authenticated-orcid":false,"given":"Ferhat","family":"Ekinci","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Manisa Celal Bayar University, Manisa 45030, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1038\/nrc2982","article-title":"The molecular biology of head and neck cancer","volume":"11","author":"Leemans","year":"2011","journal-title":"Nat. Rev. Cancer"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1056\/NEJMoa0802656","article-title":"Platinum-Based Chemotherapy plus Cetuximab in Head and Neck Cancer","volume":"359","author":"Vermorken","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1915","DOI":"10.1016\/S0140-6736(19)32591-7","article-title":"Pembrolizumab alone or with chemotherapy versus cetuximab with chemotherapy for recurrent or metastatic squamous cell carcinoma of the head and neck (KEYNOTE-048): A randomised, open-label, phase 3 study","volume":"394","author":"Burtness","year":"2019","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1856","DOI":"10.1056\/NEJMoa1602252","article-title":"Nivolumab for Recurrent Squamous-Cell Carcinoma of the Head and Neck","volume":"375","author":"Ferris","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1016\/j.annonc.2020.07.011","article-title":"Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx: EHNS-ESMO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"31","author":"Machiels","year":"2020","journal-title":"Ann. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Jafri, S.H., Shi, R., and Mills, G. (2013). Advance lung cancer inflammation index (ALI) at diagnosis is a prognostic marker in patients with metastatic non-small cell lung cancer (NSCLC): A retrospective review. BMC Cancer, 13.","DOI":"10.1186\/1471-2407-13-158"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"166","DOI":"10.2478\/raon-2013-0014","article-title":"A review of the treatment options for skin rash induced by EGFR-targeted therapies: Evidence from randomized clinical trials and a meta-analysis","volume":"47","author":"Ocvirk","year":"2013","journal-title":"Radiol. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.oraloncology.2015.11.019","article-title":"Clinical recommendations for defining platinum unsuitable head and neck cancer patient populations on chemoradiotherapy: A literature review","volume":"53","author":"Ahn","year":"2016","journal-title":"Oral Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.1038\/sj.bjc.6605979","article-title":"Cancer and renal insufficiency results of the BIRMA study","volume":"103","author":"Janus","year":"2010","journal-title":"Br. J. Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1056\/NEJMra1715715","article-title":"Head and Neck Cancer","volume":"382","author":"Chow","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1056\/NEJMoa0912217","article-title":"Human papillomavirus and survival of patients with oropharyngeal cancer","volume":"363","author":"Ang","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1056\/NEJMoa053422","article-title":"Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck","volume":"354","author":"Bonner","year":"2006","journal-title":"N. Engl. J. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1007\/s11912-016-0539-4","article-title":"The Obesity Paradox in Cancer: A Review","volume":"18","author":"Lennon","year":"2016","journal-title":"Curr. Oncol. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1146\/annurev.nutr.26.061505.111151","article-title":"Cancer-associated cachexia and underlying biological mechanisms","volume":"26","author":"Baracos","year":"2006","journal-title":"Annu. Rev. Nutr."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/5852\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T10:09:10Z","timestamp":1785146950000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/5852"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,27]]},"references-count":14,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["jcm15155852"],"URL":"https:\/\/doi.org\/10.3390\/jcm15155852","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,27]]}}}