Neoadjuvant PD-1/PD-L1 Inhibitors for Resectable Head and Neck Cancer A Systematic Review and Meta-analysis

被引:55
作者
Masarwy, Razan [1 ]
Kampel, Liyona [1 ]
Horowitz, Gilad [1 ]
Gutfeld, Orit [2 ]
Muhanna, Nidal [1 ]
机构
[1] Tel Aviv Univ, Sackler Sch Med, Dept Otolaryngol Head & Neck & Maxillofacial Surg, Tel Aviv Sourasky Med Ctr, 6 Weizmann St, IL-6423906 Tel Aviv, Israel
[2] Tel Aviv Univ, Inst Radiat Therapy, Sackler Sch Med, Div Oncol, Tel Aviv, Israel
关键词
SQUAMOUS-CELL CARCINOMA; LOCALLY ADVANCED HEAD; INDUCTION CHEMOTHERAPY; ORAL-CAVITY; CHECKPOINT INHIBITORS; IMMUNOTHERAPY; SURGERY; NIVOLUMAB; RADIOTHERAPY; RATIONALE;
D O I
10.1001/jamaoto.2021.2191
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
IMPORTANCE The emerging approach of neoadjuvant immunotherapy for solid cancers has set the ground for the integration of programmed cell death 1 (PD-1)/PD-1 ligand 1 (PD-L1) inhibitors into the neoadjuvant setting of head and neck squamous cell carcinoma (HNSCC) treatment. OBJECTIVE To assess the reported efficacy and safety of neoadjuvant immunotherapy for resectable HNSCC. DATA SOURCES AND STUDY SELECTION Electronic databases, including PubMed (MEDLINE), Embase, the Cochrane Library, and ClinicalTrials.gov were systematically searched for published and ongoing cohort studies and randomized clinical trials that evaluate neoadjuvant immunotherapy for resectable HNSCC. The search results generated studies from 2015 to July 2021. DATA EXTRACTION AND SYNTHESIS Two investigators (R.M. and L.K.) independently identified and extracted articles for potential inclusion. Random and fixed models were used to achieve pooled odds ratios. All results are presented with 95% CIs. Data quality was assessed by means of the Cochrane Collaboration's risk of bias tool. MAIN OUTCOMES AND MEASURES The primary outcomeswere reported efficacy, evaluated by major pathological response and pathological complete response in the primary tumors and lymph nodes separately, and safety, assessed by preoperative grade 3 to 4 treatment-related adverse events and surgical delay rate. RESULTS A total of 344 patients from 10 studies were included. In 8 studies, neoadjuvant immunotherapy only was administered, and the other 2 studies combined immunotherapy with neoadjuvant chemotherapy and/or radiotherapy. The overall major pathological response rate in the primary tumor sites from studies reporting on neoadjuvant immunotherapy only was 9.7%(95% CI, 3.1%-18.9%) and the pathological complete response rate was 2.9%(95% CI, 0%-9.5%). Preoperative grade 3 to 4 treatment-related adverse events were reported at a rate of 8.4%(95% CI, 0.2%-23.2%) and surgical delay at a rate of 0% (95% CI, 0%-0.9%). There was a favorable association of neoadjuvant immunotherapy with all outcome measures. The subgroup analyses did not find one specific anti-PD-1/PD-L1 agent to be superior to another, and the favorable association was demonstrated by either immunotherapy alone or in combination with anti-CTLA-4. CONCLUSIONS AND RELEVANCE In this systematic review and meta-analysis, neoadjuvant anti-PD-1/PD-L1 immunotherapy for resectable HNSCC was well tolerated and may confer therapeutic advantages implied by histopathological response. Long-term outcomes are awaited.
引用
收藏
页码:871 / 878
页数:8
相关论文
共 47 条
[1]   Neoadjuvant plus adjuvant dabrafenib and trametinib versus standard of care in patients with high-risk, surgically resectable melanoma: a single-centre, open-label, randomised, phase 2 trial [J].
Amaria, Rodabe N. ;
Prieto, Peter A. ;
Tetzlaff, Michael T. ;
Reuben, Alexandre ;
Andrews, Miles C. ;
Ross, Merrick J. ;
Glitza, Isabella C. ;
Cormier, Janice ;
Hwu, Wen-Jen ;
Tawbi, Hussein A. ;
Patel, Sapna P. ;
Lee, Jeffrey E. ;
Gersbenwaid, Jeffrey E. ;
Spencer, Christine N. ;
Gopalakrishnan, Vancheswaran ;
Bassett, Roland ;
Simpson, Lauren ;
Mouton, Rosalind ;
Hudgens, Courtney W. ;
Zhao, Li ;
Zhu, Haifeng ;
Cooper, Zachary A. ;
Wani, Khalida ;
Lazar, Alexander ;
Hwu, Patrick ;
Diab, Adi ;
Wong, Michael K. ;
McQuade, Jennifer L. ;
Royal, Richard ;
Lucci, Anthony ;
Burton, Elizabeth M. ;
Reddy, Sangeetha ;
Sharma, Padmanee ;
Allison, James ;
Futreal, Phillip A. ;
Woodman, Scott E. ;
Davies, Michael A. ;
Wargo, Jennifer A. .
LANCET ONCOLOGY, 2018, 19 (02) :181-193
[2]   Current Panorama and Challenges for Neoadjuvant Cancer Immunotherapy [J].
Benitez, Jose Carlos ;
Remon, Jordi ;
Besse, Benjamin .
CLINICAL CANCER RESEARCH, 2020, 26 (19) :5068-5077
[3]   Preoperative chemotherapy in advanced resectable OCSCC: long-term results of a randomized phase III trial [J].
Bossi, P. ;
Lo Vullo, S. ;
Guzzo, M. ;
Mariani, L. ;
Granata, R. ;
Orlandi, E. ;
Locati, L. ;
Scaramellini, G. ;
Fallai, C. ;
Licitra, L. .
ANNALS OF ONCOLOGY, 2014, 25 (02) :462-466
[4]  
Burtness B, 2018, ANN ONCOL, V29
[5]  
[陈月红 Chen Yuehong], 2014, [中国循证医学杂志, Chinese Journal of Evidence-Based Medicine], V14, P889
[6]   Pembrolizumab versus methotrexate, docetaxel, or cetuximab for recurrent or metastatic head-and-neck squamous cell carcinoma (KEYNOTE-040): a randomised, open-label, phase 3 study [J].
Cohen, Ezra E. W. ;
Soulieres, Denis ;
Le Tourneau, Christophe ;
Dinis, Jose ;
Licitra, Lisa ;
Ahn, Myung-Ju ;
Soria, Ainara ;
Machiels, Jean-Pascal ;
Mach, Nicolas ;
Mehra, Ranee ;
Burtness, Barbara ;
Zhang, Pingye ;
Cheng, Jonathan ;
Swaby, Ramona F. ;
Harrington, Kevin J. .
LANCET, 2019, 393 (10167) :156-167
[7]   Checkpoint inhibitors assessment in oropharynx cancer (CIAO): Safety and interim results. [J].
Ferrarotto, Renata ;
Bell, Diana ;
Rubin, M. Laura ;
Lee, J. Jack ;
Johnson, Jason Michael ;
Goepfert, Ryan ;
Phan, Jack ;
Elamin, Yasir ;
Myers, Jeffrey ;
Hessel, Amy Clark ;
Johnson, Faye M. ;
Gillison, Maura L. ;
Sikora, Andrew G. ;
Glisson, Bonnie S. ;
Gross, Neil D. .
JOURNAL OF CLINICAL ONCOLOGY, 2019, 37 (15)
[8]   Nivolumab for Recurrent Squamous-Cell Carcinoma of the Head and Neck [J].
Ferris, R. L. ;
Blumenschein, G., Jr. ;
Fayette, J. ;
Guigay, J. ;
Colevas, A. D. ;
Licitra, L. ;
Harrington, K. ;
Kasper, S. ;
Vokes, E. E. ;
Even, C. ;
Worden, F. ;
Saba, N. F. ;
Iglesias Docampo, L. C. ;
Haddad, R. ;
Rordorf, T. ;
Kiyota, N. ;
Tahara, M. ;
Monga, M. ;
Lynch, M. ;
Geese, W. J. ;
Kopit, J. ;
Shaw, J. W. ;
Gillison, M. L. .
NEW ENGLAND JOURNAL OF MEDICINE, 2016, 375 (19) :1856-1867
[9]   Neoadjuvant nivolumab for patients with resectable HPV-positive and HPV-negative squamous cell carcinomas of the head and neck in the CheckMate 358 trial [J].
Ferris, Robert L. ;
Spanos, William C. ;
Leidner, Rom ;
Goncalves, Anthony ;
Martens, Uwe M. ;
Kyi, Chrisann ;
Sharfman, William ;
Chung, Christine H. ;
Devriese, Lot A. ;
Gauthier, Helene ;
Chiosea, Simon, I ;
Vujanovic, Lazar ;
Taube, Janis M. ;
Stein, Julie E. ;
Li, Jun ;
Li, Bin ;
Chen, Tian ;
Barrows, Adam ;
Topalian, Suzanne L. .
JOURNAL FOR IMMUNOTHERAPY OF CANCER, 2021, 9 (06)
[10]   Neoadjuvant PD-1 Blockade in Resectable Lung Cancer [J].
Forde, P. M. ;
Chaft, J. E. ;
Smith, K. N. ;
Anagnostou, V. ;
Cottrell, T. R. ;
Hellmann, M. D. ;
Zahurak, M. ;
Yang, S. C. ;
Jones, D. R. ;
Broderick, S. ;
Battafarano, R. J. ;
Velez, M. J. ;
Rekhtman, N. ;
Olah, Z. ;
Naidoo, J. ;
Marrone, K. A. ;
Verde, F. ;
Guo, H. ;
Zhang, J. ;
Caushi, J. X. ;
Chan, H. Y. ;
Sidhom, J. -W. ;
Scharpf, R. B. ;
White, J. ;
Gabrielson, E. ;
Wang, H. ;
Rosner, G. L. ;
Rusch, V. ;
Wolchok, J. D. ;
Merghoub, T. ;
Taube, J. M. ;
Velculescu, V. E. ;
Topalian, S. L. ;
Brahmer, J. R. ;
Pardoll, D. M. .
NEW ENGLAND JOURNAL OF MEDICINE, 2018, 378 (21) :1976-1986