TY - JOUR
T1 - Immunotherapy improves efficacy and safety of patients with HPV positive and negative head and neck cancer
T2 - A systematic review and meta-analysis
AU - Galvis, Marisol Miranda
AU - Borges, Gabriel Alvares
AU - Oliveira, Thiago Bueno de
AU - Toledo, Isabela Porto de
AU - Castilho, Rogerio Moraes
AU - Guerra, Eliete Neves Silva
AU - Kowalski, Luiz Paulo
AU - Squarize, Cristiane Helena
N1 - Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/6
Y1 - 2020/6
N2 - Background: Despite multiple modalities used to management of head and neck squamous cell carcinoma (HNSCC), disease control remains unsatisfactory. Immunotherapy is emerging as a novel therapeutic approach. This systematic review assesses clinical data regarding immunotherapy efficacy and safety. Methods: Data from 11 clinical trials testing immunotherapy in HNSCC were assessed. We performed the meta-analysis to correlate the overall survival (OS), response rate (RR), adverse effects, HPV status, and PD-L1 expression. Results: Immunotherapy extended OS (hazard ratio = 0.77, p < 0.0001) and RR significantly (risk ratio = 1.41, p = 0.02). Patients with HPV-positive HNSCC exhibited a better RR (risk ratio = 1.29, p = 0.24) and OS (11.5 vs. 6.3 months). PD-L1 positive tumors showed a higher OS (9.9 vs. 6.5 months). Moreover, immunotherapy caused less adverse effects than standard therapy. Conclusion: Our results indicate the benefit of immunotherapy for improving RR and OS of HNSCC patients. The benefit is higher in patients with HPV and PD-L1 positive tumors.
AB - Background: Despite multiple modalities used to management of head and neck squamous cell carcinoma (HNSCC), disease control remains unsatisfactory. Immunotherapy is emerging as a novel therapeutic approach. This systematic review assesses clinical data regarding immunotherapy efficacy and safety. Methods: Data from 11 clinical trials testing immunotherapy in HNSCC were assessed. We performed the meta-analysis to correlate the overall survival (OS), response rate (RR), adverse effects, HPV status, and PD-L1 expression. Results: Immunotherapy extended OS (hazard ratio = 0.77, p < 0.0001) and RR significantly (risk ratio = 1.41, p = 0.02). Patients with HPV-positive HNSCC exhibited a better RR (risk ratio = 1.29, p = 0.24) and OS (11.5 vs. 6.3 months). PD-L1 positive tumors showed a higher OS (9.9 vs. 6.5 months). Moreover, immunotherapy caused less adverse effects than standard therapy. Conclusion: Our results indicate the benefit of immunotherapy for improving RR and OS of HNSCC patients. The benefit is higher in patients with HPV and PD-L1 positive tumors.
KW - Head and neck squamous cell carcinoma
KW - Human papillomavirus
KW - Immunotherapy
KW - Meta-analysis
KW - Programmed death-ligand 1
KW - Toxicity
UR - http://www.scopus.com/inward/record.url?scp=85084084315&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85084084315&partnerID=8YFLogxK
U2 - 10.1016/j.critrevonc.2020.102966
DO - 10.1016/j.critrevonc.2020.102966
M3 - Review article
C2 - 32371338
AN - SCOPUS:85084084315
SN - 1040-8428
VL - 150
JO - Critical Reviews in Oncology/Hematology
JF - Critical Reviews in Oncology/Hematology
M1 - 102966
ER -
