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The effects and safety of PD‐1/PD‐L1 inhibitors on head and neck cancer: A systematic review and meta‐analysis

BACKGROUND: Inhibitors of programmed cell death‐1 (PD‐1) and its ligand (PD‐L1) have been increasingly used in head and neck cancer therapy and reported to improve the outcomes with an acceptable safety profile. This systematic review and meta‐analysis was conducted to assess the benefit and risk of...

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Autores principales: Wang, Bi‐Cheng, Cao, Ru‐Bo, Li, Pin‐Dong, Fu, Chen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6792498/
https://www.ncbi.nlm.nih.gov/pubmed/31436392
http://dx.doi.org/10.1002/cam4.2510
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author Wang, Bi‐Cheng
Cao, Ru‐Bo
Li, Pin‐Dong
Fu, Chen
author_facet Wang, Bi‐Cheng
Cao, Ru‐Bo
Li, Pin‐Dong
Fu, Chen
author_sort Wang, Bi‐Cheng
collection PubMed
description BACKGROUND: Inhibitors of programmed cell death‐1 (PD‐1) and its ligand (PD‐L1) have been increasingly used in head and neck cancer therapy and reported to improve the outcomes with an acceptable safety profile. This systematic review and meta‐analysis was conducted to assess the benefit and risk of PD‐1/PD‐L1 inhibitors in patients with head and neck cancer. METHOD: The PubMed, Cochrane Library, EMBASE and Web of Science databases were systematically searched to find potentially eligible studies up to May 30, 2019. Primary outcomes were overall survival (OS), progression‐free survival (PFS), objective response rate (ORR), disease control rate (DCR) and adverse events. RESULTS: Overall, this analysis consisted of nine eligible studies, with two randomized controlled trials and seven single arm trials. In the treatment of recurrent or metastatic head and neck cancer, PD‐1 inhibitors showed significantly lower relative risk of death than standard‐of‐care therapy (odds ratio [OR] = 0.60, 95% confidence interval [CI]: 0.44‐0.82, I (2) = 0%, P = .001). Programmed cell death‐1 inhibitors also decreased the risk of disease progression, however, there was no statistically significant difference of PFS between the treatments (OR = 0.69, 95% CI: 0.48‐1.01, I (2) = 0%, P = .05). Subgroup analysis showed that human papillomavirus (HPV) positive patients had higher response rates than HPV negative patients in PD‐1/PD‐L1 inhibitors‐treated population (ORR: 18.8% vs 12.2%; DCR: 42.8% vs 34.4%). The most common any‐grade and grade ≥3 treatment‐related adverse events were fatigue (14.7%, 95% CI: 12.3%‐17.1%) and aspartate aminotransferase increased (1.6%, 95% CI: 0.3%‐2.9%), respectively. CONCLUSION: Programmed cell death‐1 inhibitors prolonged OS in comparison with standard‐of‐care therapy in recurrent or metastatic head and neck cancer patients. Human papillomavirus positive patients were superior to HPV negative patients in the treatment of PD‐1/PD‐L1 inhibitors. More phase III randomized controlled trials are warranted to confirm our findings.
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spelling pubmed-67924982019-10-21 The effects and safety of PD‐1/PD‐L1 inhibitors on head and neck cancer: A systematic review and meta‐analysis Wang, Bi‐Cheng Cao, Ru‐Bo Li, Pin‐Dong Fu, Chen Cancer Med Clinical Cancer Research BACKGROUND: Inhibitors of programmed cell death‐1 (PD‐1) and its ligand (PD‐L1) have been increasingly used in head and neck cancer therapy and reported to improve the outcomes with an acceptable safety profile. This systematic review and meta‐analysis was conducted to assess the benefit and risk of PD‐1/PD‐L1 inhibitors in patients with head and neck cancer. METHOD: The PubMed, Cochrane Library, EMBASE and Web of Science databases were systematically searched to find potentially eligible studies up to May 30, 2019. Primary outcomes were overall survival (OS), progression‐free survival (PFS), objective response rate (ORR), disease control rate (DCR) and adverse events. RESULTS: Overall, this analysis consisted of nine eligible studies, with two randomized controlled trials and seven single arm trials. In the treatment of recurrent or metastatic head and neck cancer, PD‐1 inhibitors showed significantly lower relative risk of death than standard‐of‐care therapy (odds ratio [OR] = 0.60, 95% confidence interval [CI]: 0.44‐0.82, I (2) = 0%, P = .001). Programmed cell death‐1 inhibitors also decreased the risk of disease progression, however, there was no statistically significant difference of PFS between the treatments (OR = 0.69, 95% CI: 0.48‐1.01, I (2) = 0%, P = .05). Subgroup analysis showed that human papillomavirus (HPV) positive patients had higher response rates than HPV negative patients in PD‐1/PD‐L1 inhibitors‐treated population (ORR: 18.8% vs 12.2%; DCR: 42.8% vs 34.4%). The most common any‐grade and grade ≥3 treatment‐related adverse events were fatigue (14.7%, 95% CI: 12.3%‐17.1%) and aspartate aminotransferase increased (1.6%, 95% CI: 0.3%‐2.9%), respectively. CONCLUSION: Programmed cell death‐1 inhibitors prolonged OS in comparison with standard‐of‐care therapy in recurrent or metastatic head and neck cancer patients. Human papillomavirus positive patients were superior to HPV negative patients in the treatment of PD‐1/PD‐L1 inhibitors. More phase III randomized controlled trials are warranted to confirm our findings. John Wiley and Sons Inc. 2019-08-22 /pmc/articles/PMC6792498/ /pubmed/31436392 http://dx.doi.org/10.1002/cam4.2510 Text en © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Research
Wang, Bi‐Cheng
Cao, Ru‐Bo
Li, Pin‐Dong
Fu, Chen
The effects and safety of PD‐1/PD‐L1 inhibitors on head and neck cancer: A systematic review and meta‐analysis
title The effects and safety of PD‐1/PD‐L1 inhibitors on head and neck cancer: A systematic review and meta‐analysis
title_full The effects and safety of PD‐1/PD‐L1 inhibitors on head and neck cancer: A systematic review and meta‐analysis
title_fullStr The effects and safety of PD‐1/PD‐L1 inhibitors on head and neck cancer: A systematic review and meta‐analysis
title_full_unstemmed The effects and safety of PD‐1/PD‐L1 inhibitors on head and neck cancer: A systematic review and meta‐analysis
title_short The effects and safety of PD‐1/PD‐L1 inhibitors on head and neck cancer: A systematic review and meta‐analysis
title_sort effects and safety of pd‐1/pd‐l1 inhibitors on head and neck cancer: a systematic review and meta‐analysis
topic Clinical Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6792498/
https://www.ncbi.nlm.nih.gov/pubmed/31436392
http://dx.doi.org/10.1002/cam4.2510
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