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Site of distant metastasis affects the prognosis with recurrent/metastatic head and neck squamous cell carcinoma patients treated with Nivolumab

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Abstract

Background

Nivolumab is approved for the treatment of recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). However, the influence of the site of distant metastasis on the efficacy of immune checkpoint inhibitor in R/M HNSCC remains unclear. We investigated the prognosis of R/M HNSCC patients treated with nivolumab, focusing on the site of distant metastasis.

Methods

We reviewed the data of R/M HNSCC patients treated with nivolumab between April 2017 and June 2020 at Saitama Prefectural Cancer Center. The differences in the prognosis were evaluated according to the site of distant metastasis.

Results

Of the 41 patients enrolled, 26 (63.4%) had lung metastasis, 7 (17.1%) had bone metastasis, and 4 (9.8%) had liver metastasis. Ten patients (24.4%) had single-organ distant metastasis (lung metastasis in all cases). Univariate analysis identified lung metastasis alone (single-organ distant metastasis) was associated with a significantly better prognosis [HR0.37 (95% CI) 0.14–0.97 p = 0.04], while liver metastasis was associated with a significantly worse prognosis [HR3.86 (95% CI) 1.26–11.8 p = 0.02]. Multivariate analysis identified lung metastasis alone and liver metastasis as independent prognostic factors. While 7 patients (70%) with lung metastasis alone could be continued on nivolumab treatment or received subsequent chemotherapy, only 1 patient (25%) with liver metastasis received subsequent chemotherapy.

Conclusion

The site of distant metastasis affects the prognosis of R/M HNSCC patients treated with nivolumab. Lung metastasis alone appears to be associated with a better prognosis, in that it allows easier transition to subsequent chemotherapy, while liver metastasis associates with a worse prognosis.

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Acknowledgements

I would like to thank the medical staff of the Department of Head and Neck Surgery and Oral Surgery of Saitama Prefectural Cancer Center. I am grateful to Hiroki Hara for the useful discussions and assistance in drafting this manuscript.

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Authors and Affiliations

  1. Department of Head and Neck Surgery, Saitama Prefectural Cancer Center, 780 Komuro, Ina-Machi, Kita-Adachi-Gun, Saitama, 362-0806, Japan

    Yuta Hoshi, Satoshi Shirakura, Masato Yamada, Tomonori Sugiyama, Nobuaki Koide, Satoru Tamii, Kyohei Kamata, Masaru Yokomura, Sotaro Osaki, Takafumi Ohno & Takeshi Beppu

  2. Department of Head and Neck Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan

    Yuta Hoshi, Satoshi Shirakura, Masato Yamada, Nobuaki Koide, Masaru Yokomura, Sotaro Osaki, Takafumi Ohno & Takeshi Beppu

  3. Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, 1-4-12 Kojirakawa-machi, Yamagata-shi, Yamagata, 990-8560, Japan

    Kyohei Kamata

  4. Department of Oral Surgery, Saitama Prefectural Cancer Center, 780 Komuro, Ina-Machi, Kita-Adachi-Gun, Saitama, 362-0806, Japan

    Kazuhiro Yagihara

  5. Department of Gastroenterology, Saitama Prefectural Cancer Center, 780 Komuro, Ina-Machi, Kita-Adachi-Gun, Saitama, 362-0806, Japan

    Hiroki Hara

Authors
  1. Yuta Hoshi
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  2. Satoshi Shirakura
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  3. Masato Yamada
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  6. Satoru Tamii
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  8. Masaru Yokomura
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  9. Sotaro Osaki
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  10. Takafumi Ohno
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  11. Kazuhiro Yagihara
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  12. Hiroki Hara
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  13. Takeshi Beppu
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Correspondence to Yuta Hoshi.

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Cite this article

Hoshi, Y., Shirakura, S., Yamada, M. et al. Site of distant metastasis affects the prognosis with recurrent/metastatic head and neck squamous cell carcinoma patients treated with Nivolumab. Int J Clin Oncol 28, 1139–1146 (2023). https://doi.org/10.1007/s10147-023-02381-3

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  • DOI: https://doi.org/10.1007/s10147-023-02381-3

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