Positron Emission Tomography–Computed Tomography Imaging, Genomic Profile, and Survival in Patients With Head and Neck Cancer Receiving Immunotherapy

Abstract

Identifying biomarkers that predict survival outcomes and response to treatment is an unmet need in oncology. Few biomarkers predictive of response to immune checkpoint inhibitor (ICI) drugs have been described for patients with head and neck squamous cell cancer (HNSCC). Maximum standardized uptake value (SUVmax) on positron emission tomographycomputed tomography (PET-CT) has been previously reported as a potential clinical predictor for survival outcome among patients with HNSCC. 1 Our objective was to analyze the association between SUVmax on PET-CT and survival in patients with head and neck cancer receiving ICI therapies.Methods | After approval by the Memorial Sloan Kettering Cancer Center Institutional Review Board and patient written informed consent, we analyzed clinical and genomic data from patients treated with ICI for HNSCC between 2013 and 2018. Patients who received PET-CT imaging within 180 days prior to ICI start date were included, and SUVmax was categorized as above or below the median. Other clinical and genomic covariates with prior evidence of prognostic value were analyzed, including pretreatment peripheral blood neutrophilto-lymphocyte ratio (NLR) and tumor mutation burden (TMB), as assessed using Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets (MSK-IMPACT), a targeted genomic sequencing panel of 341-468 genes. 2 The outcomes analyzed were overall and progression-free survival, and response to treatment was assessed using RECIST version 1.1 criteria. Analyses were performed using Stata version 16.