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PD-1/PD-L1 inhibitor plus chemotherapy versus standard of care in the first-line treatment for recurrent or metastatic head and neck squamous cell carcinoma

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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objective

This study aimed to evaluate the efficacy and safety of programmed cell death-1/programmed cell death-ligand 1 (PD-1/PD-L1) inhibitor plus chemotherapy vs standard of care (SoC) treatment in the first-line treatment for recurrent or metastatic head and neck squamous cell carcinoma (R/M-SCCHN).

Methods

Randomized controlled trials (RCTs) that investigated PD-1/PD-L1 inhibitor plus chemotherapy vs SoC as first-line treatment for R/M-SCCHN were searched from electronic databases (PubMed, Embase and Cochrane Library). The primary outcomes were overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and adverse events (AEs).

Results

In total, three phase 3 RCTs (KEYNOTE-048, CAPTAIN-1st, and JUPITER-02; n = 1120) with three PD-1 inhibitors (pembrolizumab, camrelizumab and toripalimab) were included in the analysis. Compared with SoC, PD-1 inhibitor plus chemotherapy significantly prolonged PFS (hazard ratio [HR] 0.66, 95% CI 0.40–0.93, p < 0.001) and OS (HR 0.73, 95% CI 0.60–0.86, p < 0.001) of patients. There was no statistical differences in ORR (odds ratio [OR] 1.26; 95% CI 0.97–1.64, p = 0.086), grade 3 or higher AEs (OR 0.77, 95% CI 0.50–1.17, p = 0.221), and treatment-related deaths (OR 1.34, 95% CI 0.60–2.98, p = 0.470) between the two groups.

Conclusion

PD-1 inhibitor plus chemotherapy showed more survival benefit than SoC in the first-line treatment for R/M-SCCHN, with a similar safety profile.

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Abbreviations

R/M-SCCHN:

Recurrent or metastatic head and neck squamous cell carcinoma

RCT:

Randomized controlled trial

OS:

Overall survival

PFS:

Progression-free survival

AE:

Adverse event

ORR:

Objective response rate

PD-1:

Programmed cell death protein-1

PD-L1:

Programmed cell death 1 ligand 1

CTLA-4:

Cytotoxic T lymphocyte antigen 4

HR:

Hazard ratio

OR:

Odds ratio

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Acknowledgements

The authors would like to thank The Third Affiliated Hospital of Guangxi Medical University.

Funding

This study was funded in part by the Self-Raised Scientific Research Fund of the Ministry of Health of Guangxi Province (Grant/Award number: Z20200080).

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Authors and Affiliations

  1. Radiotherapy Department, The Third Affiliated Hospital of Guangxi Medical University, Dan-Cun Road No.13, Nanning, 530000, Guangxi, China

    Dun-Chang Mo, Jian-Feng Huang, Peng-Hui Luo, Biao Zou & Han-Lei Wang

  2. ENT & HN Surgery Department, The Third Affiliated Hospital of Guangxi Medical University, Nanning, 530000, Guangxi, China

    Long Chen

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  1. Dun-Chang Mo
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Contributions

MDC and HJF contributed to the study design and writing. CL and LPH performed the data collection and selection. ZB and WHL performed the data analysis. All authors read and approved the final manuscript.

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Correspondence to Dun-Chang Mo.

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Mo, DC., Huang, JF., Luo, PH. et al. PD-1/PD-L1 inhibitor plus chemotherapy versus standard of care in the first-line treatment for recurrent or metastatic head and neck squamous cell carcinoma. Eur Arch Otorhinolaryngol 280, 1–9 (2023). https://doi.org/10.1007/s00405-022-07571-9

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