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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
BACKGROUND: Immune checkpoint inhibitors (ICIs) showed antitumor activity for recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). However, the results from different studies were controversial. METHODS: Online databases were searched for randomized clinical trials (RCTs) evalu...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10652313/ https://www.ncbi.nlm.nih.gov/pubmed/37814950 http://dx.doi.org/10.1002/cam4.6564 |
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author | Dang, Shoutao Zhang, Shurong Zhao, Jingyang Li, Xinyu Li, Wei |
author_facet | Dang, Shoutao Zhang, Shurong Zhao, Jingyang Li, Xinyu Li, Wei |
author_sort | Dang, Shoutao |
collection | PubMed |
description | BACKGROUND: Immune checkpoint inhibitors (ICIs) showed antitumor activity for recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). However, the results from different studies were controversial. METHODS: Online databases were searched for randomized clinical trials (RCTs) evaluating ICIs for R/M HNSCC. The characteristics of the studies and the results of overall survival (OS), progression‐free survival (PFS), objective response rate (ORR), treatment‐related adverse events (TRAEs) were extracted. RESULTS: A total of 4936 patients from eight studies were included. Anti‐PD1/PDL1 monotherapy significantly improved OS in total population (hazard ratio, HR, 0.87, 95% CI, 0.79–0.95, p = 0.003) and PD‐L1 high expression patients (HR, 0.71, 95% CI, 0.55–0.90, p = 0.006) with significant lower incidence of any grade TRAEs (odds ratio, OR, 0.16, 95% CI, 0.07–0.37, p < 0.00001) and Grades 3–5 TRAEs (OR, 0.18, 95% CI, 0.10–0.33, p < 0.0001) compared with standard of care (SOC); however, the pooled results of PFS and ORR were not significant different. PD1/PDL1 inhibitors plus CTLA4 inhibitors did not improve OS, PFS, ORR compared with SOC or ICIs monotherapy; however, the incidence of Grades 3–5 TRAEs was significant higher compared with ICIs monotherapy (OR, 1.80, 95% CI, 1.34–2.41, p = 0.0001). CONCLUSIONS: Anti‐PD1/PDL1 monotherapy could improve OS for R/M HNSCC with significant lower incidence of TRAEs compared with SOC. PD1/PDL1 inhibitors plus CTLA4 inhibitors showed no more benefit compared with both SOC and ICIs monotherapy, but the incidence of Grades 3–5 TRAEs was significant higher compared with ICIs monotherapy. |
format | Online Article Text |
id | pubmed-10652313 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-106523132023-10-10 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 Dang, Shoutao Zhang, Shurong Zhao, Jingyang Li, Xinyu Li, Wei Cancer Med RESEARCH ARTICLES BACKGROUND: Immune checkpoint inhibitors (ICIs) showed antitumor activity for recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). However, the results from different studies were controversial. METHODS: Online databases were searched for randomized clinical trials (RCTs) evaluating ICIs for R/M HNSCC. The characteristics of the studies and the results of overall survival (OS), progression‐free survival (PFS), objective response rate (ORR), treatment‐related adverse events (TRAEs) were extracted. RESULTS: A total of 4936 patients from eight studies were included. Anti‐PD1/PDL1 monotherapy significantly improved OS in total population (hazard ratio, HR, 0.87, 95% CI, 0.79–0.95, p = 0.003) and PD‐L1 high expression patients (HR, 0.71, 95% CI, 0.55–0.90, p = 0.006) with significant lower incidence of any grade TRAEs (odds ratio, OR, 0.16, 95% CI, 0.07–0.37, p < 0.00001) and Grades 3–5 TRAEs (OR, 0.18, 95% CI, 0.10–0.33, p < 0.0001) compared with standard of care (SOC); however, the pooled results of PFS and ORR were not significant different. PD1/PDL1 inhibitors plus CTLA4 inhibitors did not improve OS, PFS, ORR compared with SOC or ICIs monotherapy; however, the incidence of Grades 3–5 TRAEs was significant higher compared with ICIs monotherapy (OR, 1.80, 95% CI, 1.34–2.41, p = 0.0001). CONCLUSIONS: Anti‐PD1/PDL1 monotherapy could improve OS for R/M HNSCC with significant lower incidence of TRAEs compared with SOC. PD1/PDL1 inhibitors plus CTLA4 inhibitors showed no more benefit compared with both SOC and ICIs monotherapy, but the incidence of Grades 3–5 TRAEs was significant higher compared with ICIs monotherapy. John Wiley and Sons Inc. 2023-10-10 /pmc/articles/PMC10652313/ /pubmed/37814950 http://dx.doi.org/10.1002/cam4.6564 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 | RESEARCH ARTICLES Dang, Shoutao Zhang, Shurong Zhao, Jingyang Li, Xinyu Li, Wei 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 |
title | 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 |
title_full | 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 |
title_fullStr | 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 |
title_full_unstemmed | 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 |
title_short | 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 |
title_sort | 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 |
topic | RESEARCH ARTICLES |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10652313/ https://www.ncbi.nlm.nih.gov/pubmed/37814950 http://dx.doi.org/10.1002/cam4.6564 |
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