Cargando…
A systematic review of neoadjuvant and definitive immunotherapy in locally advanced head and neck squamous cell carcinoma
BACKGROUND: Patients with locally advanced head and neck squamous cell carcinoma (HNSCC) require multi‐modality treatment. Immune checkpoint inhibitors (ICIs) are now standard of care in management of recurrent/metastatic HNSCC. However, its role in the definitive and neoadjuvant setting remains unc...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10242857/ https://www.ncbi.nlm.nih.gov/pubmed/36934434 http://dx.doi.org/10.1002/cam4.5815 |
_version_ | 1785054309003558912 |
---|---|
author | Nindra, Udit Hurwitz, Joshua Forstner, Dion Chin, Venessa Gallagher, Richard Liu, Jia |
author_facet | Nindra, Udit Hurwitz, Joshua Forstner, Dion Chin, Venessa Gallagher, Richard Liu, Jia |
author_sort | Nindra, Udit |
collection | PubMed |
description | BACKGROUND: Patients with locally advanced head and neck squamous cell carcinoma (HNSCC) require multi‐modality treatment. Immune checkpoint inhibitors (ICIs) are now standard of care in management of recurrent/metastatic HNSCC. However, its role in the definitive and neoadjuvant setting remains unclear. METHODS: A literature search was conducted that included all articles investigating ICI in untreated locally advanced (LA) HNSCC. Data was extracted and summarised and rated for quality using the Cochrane risk of bias tool. RESULTS: Of 1086 records, 29 met the final inclusion criteria. In both concurrent and neoadjuvant settings, the addition of ICI was safe and did not delay surgery or reduce chemoradiotherapy completion. In the concurrent setting, although ICI use demonstrates objective responses in all published trials, there has not yet been published data to with PFS or OS benefit. In the neoadjuvant setting, combination ICI resulted in superior major pathological response rates compared to ICI monotherapy without a significant increase adverse event profiles, but its value in improving survival is not clear. ICI efficacy appears to be affected by tumour characteristics, in particular PD‐L1 combined positive score, HPV status and the tumour microenvironment. CONCLUSIONS: There is significant heterogeneity of ICI use in untreated LA HNSCC with multiple definitive concurrent and neoadjuvant protocols used. Resultantly, conclusions regarding the survival benefits of adding ICI to standard‐of‐care regimens cannot be made. Further trials and translational studies are required to elucidate optimal ICI sequencing in the definitive setting as well as better define populations more suited for neoadjuvant protocols. |
format | Online Article Text |
id | pubmed-10242857 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-102428572023-06-07 A systematic review of neoadjuvant and definitive immunotherapy in locally advanced head and neck squamous cell carcinoma Nindra, Udit Hurwitz, Joshua Forstner, Dion Chin, Venessa Gallagher, Richard Liu, Jia Cancer Med REVIEW BACKGROUND: Patients with locally advanced head and neck squamous cell carcinoma (HNSCC) require multi‐modality treatment. Immune checkpoint inhibitors (ICIs) are now standard of care in management of recurrent/metastatic HNSCC. However, its role in the definitive and neoadjuvant setting remains unclear. METHODS: A literature search was conducted that included all articles investigating ICI in untreated locally advanced (LA) HNSCC. Data was extracted and summarised and rated for quality using the Cochrane risk of bias tool. RESULTS: Of 1086 records, 29 met the final inclusion criteria. In both concurrent and neoadjuvant settings, the addition of ICI was safe and did not delay surgery or reduce chemoradiotherapy completion. In the concurrent setting, although ICI use demonstrates objective responses in all published trials, there has not yet been published data to with PFS or OS benefit. In the neoadjuvant setting, combination ICI resulted in superior major pathological response rates compared to ICI monotherapy without a significant increase adverse event profiles, but its value in improving survival is not clear. ICI efficacy appears to be affected by tumour characteristics, in particular PD‐L1 combined positive score, HPV status and the tumour microenvironment. CONCLUSIONS: There is significant heterogeneity of ICI use in untreated LA HNSCC with multiple definitive concurrent and neoadjuvant protocols used. Resultantly, conclusions regarding the survival benefits of adding ICI to standard‐of‐care regimens cannot be made. Further trials and translational studies are required to elucidate optimal ICI sequencing in the definitive setting as well as better define populations more suited for neoadjuvant protocols. John Wiley and Sons Inc. 2023-03-19 /pmc/articles/PMC10242857/ /pubmed/36934434 http://dx.doi.org/10.1002/cam4.5815 Text en © 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | REVIEW Nindra, Udit Hurwitz, Joshua Forstner, Dion Chin, Venessa Gallagher, Richard Liu, Jia A systematic review of neoadjuvant and definitive immunotherapy in locally advanced head and neck squamous cell carcinoma |
title | A systematic review of neoadjuvant and definitive immunotherapy in locally advanced head and neck squamous cell carcinoma |
title_full | A systematic review of neoadjuvant and definitive immunotherapy in locally advanced head and neck squamous cell carcinoma |
title_fullStr | A systematic review of neoadjuvant and definitive immunotherapy in locally advanced head and neck squamous cell carcinoma |
title_full_unstemmed | A systematic review of neoadjuvant and definitive immunotherapy in locally advanced head and neck squamous cell carcinoma |
title_short | A systematic review of neoadjuvant and definitive immunotherapy in locally advanced head and neck squamous cell carcinoma |
title_sort | systematic review of neoadjuvant and definitive immunotherapy in locally advanced head and neck squamous cell carcinoma |
topic | REVIEW |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10242857/ https://www.ncbi.nlm.nih.gov/pubmed/36934434 http://dx.doi.org/10.1002/cam4.5815 |
work_keys_str_mv | AT nindraudit asystematicreviewofneoadjuvantanddefinitiveimmunotherapyinlocallyadvancedheadandnecksquamouscellcarcinoma AT hurwitzjoshua asystematicreviewofneoadjuvantanddefinitiveimmunotherapyinlocallyadvancedheadandnecksquamouscellcarcinoma AT forstnerdion asystematicreviewofneoadjuvantanddefinitiveimmunotherapyinlocallyadvancedheadandnecksquamouscellcarcinoma AT chinvenessa asystematicreviewofneoadjuvantanddefinitiveimmunotherapyinlocallyadvancedheadandnecksquamouscellcarcinoma AT gallagherrichard asystematicreviewofneoadjuvantanddefinitiveimmunotherapyinlocallyadvancedheadandnecksquamouscellcarcinoma AT liujia asystematicreviewofneoadjuvantanddefinitiveimmunotherapyinlocallyadvancedheadandnecksquamouscellcarcinoma AT nindraudit systematicreviewofneoadjuvantanddefinitiveimmunotherapyinlocallyadvancedheadandnecksquamouscellcarcinoma AT hurwitzjoshua systematicreviewofneoadjuvantanddefinitiveimmunotherapyinlocallyadvancedheadandnecksquamouscellcarcinoma AT forstnerdion systematicreviewofneoadjuvantanddefinitiveimmunotherapyinlocallyadvancedheadandnecksquamouscellcarcinoma AT chinvenessa systematicreviewofneoadjuvantanddefinitiveimmunotherapyinlocallyadvancedheadandnecksquamouscellcarcinoma AT gallagherrichard systematicreviewofneoadjuvantanddefinitiveimmunotherapyinlocallyadvancedheadandnecksquamouscellcarcinoma AT liujia systematicreviewofneoadjuvantanddefinitiveimmunotherapyinlocallyadvancedheadandnecksquamouscellcarcinoma |