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Outcomes and Biomarkers of Immune Checkpoint Inhibitor Therapy in Patients with Refractory Head and Neck Squamous Cell Carcinoma: KCSG HN18-12

 Yun-Gyoo Lee  ;  Hyun Chang  ;  Bhumsuk Keam  ;  Sang Hoon Chun  ;  Jihyun Park  ;  Keon Uk Park  ;  Seong Hoon Shin  ;  Ho Jung An  ;  Kyoung Eun Lee  ;  Keun-Wook Lee  ;  Hye Ryun Kim  ;  Sung-Bae Kim  ;  Myung-Ju Ahn  ;  In Gyu Hwang 
 CANCER RESEARCH AND TREATMENT, Vol.53(3) : 671-677, 2021-07 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Clinical Decision-Making ; Drug Resistance, Neoplasm ; Female ; Follow-Up Studies ; Head and Neck Neoplasms / blood ; Head and Neck Neoplasms / drug therapy* ; Head and Neck Neoplasms / mortality ; Head and Neck Neoplasms / pathology ; Humans ; Immune Checkpoint Inhibitors / pharmacology ; Immune Checkpoint Inhibitors / therapeutic use* ; Lymphocyte Count ; Lymphocytes ; Male ; Middle Aged ; Neoplasm Recurrence, Local / blood ; Neoplasm Recurrence, Local / drug therapy* ; Neoplasm Recurrence, Local / mortality ; Neutrophils ; Patient Selection ; Prognosis ; Progression-Free Survival ; Retrospective Studies ; Risk Assessment / methods ; Squamous Cell Carcinoma of Head and Neck / blood ; Squamous Cell Carcinoma of Head and Neck / drug therapy* ; Squamous Cell Carcinoma of Head and Neck / mortality ; Squamous Cell Carcinoma of Head and Neck / secondary
Biomarkers ; Head and neck neoplasms ; Immune check point ; Platinum refractory ; Sum of target lesions
Purpose: This study was conducted to determine the effectiveness of immune checkpoint inhibitors (ICIs) in recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) after platinum-containing chemotherapy. We also identified clinical biomarkers which may be predictive of patient prognosis.

Materials and methods: We analyzed 125 patients with R/M HNSCC who received ICIs, retrospectively. Overall response rate (ORR) was the primary study outcome. Overall survival (OS) and progression-free survival (PFS) were the secondary study outcomes.

Results: The patients received anti-programmed cell death protein-1 (PD-1) (n=73, 58%), anti-programmed death-ligand 1 (PD-L1) (n=24, 19%), or a combination of anti-PD-1/PD-L1 and anti-cytotoxic T-lymphocyte antigen 4 (n=28, 22%). The median age was 57 years (range, 37 to 87). The location of the primary tumor was in the oral cavity in 28% of the cases, followed by oropharynx (27%), hypopharynx (20%), and larynx (12%). The ORR was 15% (19/125). With 12.3 months of median follow-up, median PFS was 2.7 months. Median OS was 10.8 months. A neutrophil-to-lymphocyte ratio (NLR) > 4 was significantly associated with poor response to ICIs (odds ratio, 0.30; p=0.022). A sum of the target lesions > 40 mm (hazard ratio [HR], 1.53; p=0.046] and a NLR > 4 (HR, 1.75; p=0.009) were considered to be predictive markers of short PFS. A poor performance status (HR, 4.79; p < 0.001), a sum of target lesions > 40 mm (HR, 1.93; p=0.025), and an NLR > 4 (HR, 3.36; p < 0.001) were the significant predictors for poor survival.

Conclusion: ICIs exhibited favorable antitumor activity in R/M HNSCC. Clinically, our findings can be used to recognize patients benefit from receiving ICI.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hye Ryun(김혜련) ORCID logo https://orcid.org/0000-0002-1842-9070
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