Combination therapy with immune checkpoint inhibitors in recurrent or metastatic squamous cell carcinoma of the head and neck: A meta-analysis

• Published in: International immunopharmacology 2023-06, Vol.119, p.110270-110270, Article 110270
• Main Authors: Chen, Long, Mo, Dun-Chang, Hu, Min, He, Wei, Yang, Qiang-Wei, Tang, Jun
• Format: Article
• Language: English
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cetuximab; Combined Modality Therapy; Head and Neck Neoplasms - drug therapy; Humans; Immune checkpoint inhibitor; Immune Checkpoint Inhibitors - therapeutic use; Immunotherapy; Lung Neoplasms - drug therapy; Meta-analysis; PD-1/PD-L1; Squamous Cell Carcinoma of Head and Neck - drug therapy; Squamous cell carcinoma of the head and neck
• ISSN: 1567-5769; 1878-1705
• DOI: 10.1016/j.intimp.2023.110270

•Immunotherapy benefit patients with recurrent or metastatic head and neck squamous cell carcinoma.•PD-1 inhibitor plus chemotherapy enhanced OS, PFS, and ORR of patients.•Double-agent immunotherapy could not improve OS, PFS, and ORR.•Immune checkpoint inhibitor (ICI) combination therapy was well tolerated. To evaluate the efficacy and safety of immune checkpoint inhibitor (ICI) combination therapy in the first-line treatment for recurrent or metastatic squamous cell carcinoma of the head and neck (R/M-SCCHN). We conducted a meta-analysis between ICI combination therapy and standard of care (SOC) treatment (chemotherapy with or without cetuximab) in R/M-SCCHN based on randomized controlled trials (RCTs). The outcomes were overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and adverse events (AEs). Five RCTs involving 2576 patients were included in the analysis. Compared with SOC, PD-1 inhibitor plus chemotherapy significantly improved OS (hazard ratio [HR], 0.73, 95 % CI 0.62–0.87, p = 0.0004), PFS (HR, 0.65, 95 % CI 0.43–0.99, p = 0.04) and ORR (risk ratio [RR], 1.10; 95 % CI 1.01–1.19, p = 0.02) of patients, while double-agent immunotherapy could not improve either the outcome of OS, PFS, or ORR (all p > 0.05). In safety analyses, combination immunotherapy showed similar risks of grade 3 or higher treatment-related AEs (RR, 0.79, 95 % CI 0.56–1.11, P = 0.17) and treatment-related deaths (RR, 1.16, 95 % CI 0.65–2.07, P = 0.63) compared to SOC. Compared with SOC, PD-1 inhibitor plus chemotherapy enhanced OS, PFS, and ORR in the first-line treatment for patients with R/M-SCCHN, but double-agent immunotherapy showed no more benefit for these patients.