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Immune checkpoint inhibitors show efficacy against advanced head and neck cancer

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Anti-PD1/PDL1 monotherapy has shown significant promise in improving overall survival (OS) for patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC), while also resulting in a lower incidence of treatment-related adverse events (TRAEs) compared to the standard of care (SOC), according to a study.

However, the combination of PD1/PDL1 inhibitors with CTLA4 inhibitors did not yield substantial benefits in OS, progression-free survival (PFS), or objective response rate (ORR), and it led to a higher risk of severe adverse events, suggesting that anti-PD1/PDL1 monotherapy could be a more effective treatment option for R/M HNSCC patients.

A total of 8 studies involving 4936 patients were included in the analysis.

The findings showed that anti-PD1/PDL1 monotherapy demonstrated a marked improvement in overall survival (OS) for both the entire study population and patients with high PD-L1 expression. The hazard ratios (HR) for OS were recorded at 0.87 (95% CI, 0.79-0.95, P = 0.003) and 0.71 (95% CI, 0.55-0.90, P = 0.006) respectively, compared to the standard of care (SOC). The incidence of any grade TRAEs exhibited a significant reduction (odds ratio, OR, 0.16, 95% CI, 0.07-0.37, P < 0.00001), as well as Grades 3-5 TRAEs (OR, 0.18, 95% CI, 0.10-0.33, p < 0.0001) in comparison to the SOC.

However, pooled results for PFS and ORR did not exhibit significant differences when compared with SOC.

Dang S, Zhang S, Zhao J, Li X, Li W. Efficacy and safety of immune checkpoint inhibitors in recurrent or metastatic head and neck squamous cell carcinoma: A systematic review and meta-analysis of randomized clinical trials. Cancer Med. 2023;doi: 10.1002/cam4.6564. Epub ahead of print. PMID: 37814950.