Immune checkpoint inhibitors in head and neck squamous cell carcinoma: A systematic review of phase-3 clinical trials

Poulose, Jissy Vijo; Kainickal, C.T.

doi:10.5306/wjco.v13.i5.388

Cited by 25 publications

(16 citation statements)

References 83 publications

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“…On the other hand, immunotherapy is widely applied as an effective method to treat HNSCC, but the overall response rate remains low. After years of exploring HNSCC prognostic signatures, while some simple signatures can forecast immunotherapy and OS ( Fasano et al, 2022 ; Poulose and Kainickal, 2022 ), single prognostic signatures cannot very well predict which patients can benefit from immunotherapy. Compound signatures constructed by combining multiple signatures can further differentiate the prognosis and immune response of patients with diverse OS, which will contribute to our understanding of anti-tumor immune response of TIME and guide more effective immunotherapy strategies.…”

Section: Discussionmentioning

confidence: 99%

“…Immunotherapy, including immune checkpoint inhibitor therapy (anti-PD-1/L1, anti-CTLA-4, etc. ), chimeric antigen receptor macrophages (CAR-M), and anti-tumor-associated macrophages (anti-TAMs), has shown promise in treatment of HNSCC, but only a small percentage of HNSCC patients have sustained immune responses ( Evrard et al, 2019 ; Malfitano et al, 2020 ; Cheng et al, 2021 ; Sloas et al, 2021 ; Fasano et al, 2022 ; Poulose and Kainickal, 2022 ). Many studies have shown that immune-related gene prognostic index (IRGPI) may be a potential signature of immunotherapy for a variety of tumors.…”

Section: Introductionmentioning

confidence: 99%

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A composite score based on immune-related gene prognostic index and m6A risk score of head and neck squamous cell carcinoma

Yang

Cai²,

Huang³

et al. 2023

Front. Genet.

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Background: Immunotherapy has been demonstrated favorable in head and neck squamous cell carcinoma (HNSCC). Studies indicated that immune-related gene prognostic index (IRGPI) was a robust signature, and N6-methyladenosine (m6A) methylation had a significant impact on the tumor immune microenvironment (TIME) and immunotherapy of head and neck squamous cell carcinoma. Thus, combining indicated that immune-related gene prognostic index with m6A status should offer a better predictive power for immune responses.Methods: Head and neck squamous cell carcinoma samples from the cancer genome atlas (TCGA, n = 498) and gene expression omnibus database (GSE65858, n = 270) were used in this study. Cox regression analysis was used to construct the indicated that immune-related gene prognostic index through immune-related hub genes which were identified by weighted gene co-expression network analysis (WGCNA). The m6A risk score was constructed by least absolute shrinkage and selection operator (LASSO) regression analysis. Principal component analysis was used to construct a composite score, and systematically correlate subgroups according to tumor immune microenvironment cell-infiltrating characteristics.Results: A composite score was determined based on indicated that immune-related gene prognostic index and m6A risk score. Head and neck squamous cell carcinoma patients in the cancer genome atlas were divided into four subgroups: A (IRGPI-High&m6A-risk-High, n = 127), B (IRGPI-High&m6A-risk-Low, n = 99), C (IRGPI-Low&m6A-risk-High, n = 99), and D (IRGPI-Low&m6A-risk-Low, n = 128), and overall survival (OS) was significantly different between subgroups (p < 0.001). The characteristics of tumor immune microenvironment cell infiltration in the four subgroups were significantly different in subgroups (p < 0.05). The receiver operating characteristic (ROC) curves show the predictive value of composite score for overall survival was superior to other scores.Conclusion: The composite score is a promising prognostic signature which might distinguish immune and molecular characteristics, predict prognosis, and guide more effective immunotherapeutic strategies for head and neck squamous cell carcinoma.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A composite score based on immune-related gene prognostic index and m6A risk score of head and neck squamous cell carcinoma

Yang

Cai²,

Huang³

et al. 2023

Front. Genet.

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“…Thus, increased PD-L1 protein expression allows cancer cells to evade the body's immune response. Instead, targeting the PD-1/PD-L1/2 pathway allows for the activation of anti-tumour immunity and better cancer treatment [2,14,20,23,28].…”

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confidence: 99%

“…With a median survival of 7.4 months for patients treated with platinum-based chemotherapy and some patients becoming resistant to platinum and dying within 4 months, recurrent or metastatic HN-SCC is a significant problem [16,18,23].…”

mentioning

confidence: 99%

“…Advances in immunotherapy have led to a paradigm shift in the treatment of incurable R/M HN-SCC. HNSCC tumour cells have high levels of PD-L expression (ranging from 50 -60 % [11] to 85 % [23], depending on the assay method). The presence of an inhibitor of the PD-1 immune checkpoint, such as pembrolizumab, significantly increases the potential for treating patients.…”

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confidence: 99%

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Pembrolizumab as an immunotherapy drug in the treatment of a patient with recurrent (unresectable) cancer of the lower lip

Markulan

Makarevych

2022

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Advances in immunotherapy have changed approaches to the treatment of recurrent and/or metastatic head and neck squamous cell carcinoma (R/M HNSCC). The US Food and Drug Administration (the FDA) has approved both pembrolizumab monotherapy for first‑line treatment of the tumours expressing the programmed cell death receptor‑1 (PD‑L1; combined positive score of ≥ 1) in patients with R/M HNSCC and pembrolizumab administration in combination with platinum and fluorouracil regardless of the level of PD‑L1 expression. Pembrolizumab is a humanized monoclonal antibody class drug that activates the anti‑tumour immune response. Objective — to present treatment outcomes for recurrent (unresectable) cancer of the lower lip that was treated using a pembrolizumab monotherapy regimen. Patient H., born in 1968, received a 20‑month combined therapy for cancer of the lower lip. He had radical surgical removal of the primary tumour and two surgical resections of metastases, as well as courses of both remote gamma‑therapy and polychemotherapy. Nevertheless, the disease progressed from T2N0M0 to T4N1M0. In the area of the chin and right cheek, the patient developed a defect of the skin and subcutaneous tissue measuring 18 ´ 10 cm with purulent‑necrotic margins and an external fistula of the oral cavity. He was also bothered by unbearable pain in the area of the tumour and an unpleasant odour from the mouth and from the tumour. The patient was prescribed immunotherapy with pembrolizumab since an immunohistochemical examination revealed an RD‑L1‑positive tumour. One year after the start of immunotherapy, which included 17 courses of cancer treatment, the wound healed and the patient’s quality of life significantly improved. No adverse reactions were observed during immunotherapy. Computed tomography revealed a 25 x 15 mm nodule at the level of the lower jaw on the right and a lymph node of about 10 mm in diameter in the area of the lower parts of the right parotid salivary gland. Distant metastases were not detected. Currently, immunotherapy is ongoing. The issue of surgical removal of pathological formations is under consideration. This case demonstrates the positive outcomes of a pembrolizumab monotherapy regimen in a patient with R/M HNSCC.

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First‐line immunotherapy combinations for recurrent or metastatic nasopharyngeal carcinoma: An updated network meta‐analysis and cost‐effectiveness analysis

et al. 2023

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ObjectivesRecently updated results of randomized clinical trials (RCTs) have confirmed that toripalimab, camrelizumab, and tislelizumab plus chemotherapy (TOGP, CAGP, and TIGP) significantly prolonged survival compared to placebo plus chemotherapy (PLGP) in the first‐line treatment for recurrent or metastatic nasopharyngeal carcinoma (R/M‐NPC). However, the high cost of immunotherapies imposes a huge financial burden on patients and health care systems.Materials and methodsRCTs estimating immunotherapies for R/M‐NPC were searched. A Bayesian network meta‐analysis (NMA) was carried out; the main outcomes were hazard ratios (HRs) of overall survival (OS) and progression‐free survival (PFS). The cost and efficacy of four first‐line therapies were evaluated using the Markov model. The main outcome in the cost‐effectiveness analysis (CEA) was incremental cost‐utility ratios (ICURs). The model robustness was assessed by one‐way, three‐way, and probabilistic sensitivity analyses.ResultsThree RCTs (JUPITER‐02, CAPTAIN‐1st, and RATIONALE‐309) involving 815 patients were included in the NMA. Compared with PLGP, chemo‐immunotherapies have significantly longer PFS and OS. Compared to the PLGP group, TOGP, CAGP, and TIGP groups resulted in additional costs of $48 339, $22 900, and $23 162, with additional 1.89, 0.73, and 0.960 QALYs, respectively, leading to the ICURs of $25 576/QALY, $31 370/QALY, and $31 729/QALY. Pairwise comparisons showed TOGP was the most cost‐effective option among chemo‐immunotherapy groups.ConclusionFrom the Chinese payers' perspective, first‐line immunotherapy combination therapies provided significant survival and cost‐effectiveness superiority over chemotherapy alone for patients with R/M‐NPC at the WTP of $38 029/QALY. Among the three chemo‐immunotherapy groups, TOGP was the most cost‐effective option.

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Immune checkpoint inhibitors in head and neck squamous cell carcinoma: A systematic review of phase-3 clinical trials

Cited by 25 publications

References 83 publications

A composite score based on immune-related gene prognostic index and m6A risk score of head and neck squamous cell carcinoma

A composite score based on immune-related gene prognostic index and m6A risk score of head and neck squamous cell carcinoma

Pembrolizumab as an immunotherapy drug in the treatment of a patient with recurrent (unresectable) cancer of the lower lip

First‐line immunotherapy combinations for recurrent or metastatic nasopharyngeal carcinoma: An updated network meta‐analysis and cost‐effectiveness analysis

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