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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...

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Autores principales: Dang, Shoutao, Zhang, Shurong, Zhao, Jingyang, Li, Xinyu, Li, Wei
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/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.
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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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