Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil; Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA; Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil.
Crit Rev Oncol Hematol. 2020 Jun;150:102966. doi: 10.1016/j.critrevonc.2020.102966. Epub 2020 Apr 22.
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.
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.
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.
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.
尽管采用了多种方法来治疗头颈部鳞状细胞癌（HNSCC），但疾病控制仍不尽如人意。免疫疗法作为一种新的治疗方法正在出现。本系统评价评估了免疫疗法治疗 HNSCC 的临床数据，评估其疗效和安全性。
评估了 11 项测试免疫疗法治疗 HNSCC 的临床试验的数据。我们进行了荟萃分析，以评估总生存期（OS）、缓解率（RR）、不良反应、HPV 状态和 PD-L1 表达的相关性。
免疫疗法显著延长了 OS（风险比=0.77，p<0.0001）和 RR（风险比=1.41，p=0.02）。HPV 阳性的 HNSCC 患者具有更好的 RR（风险比=1.29，p=0.24）和 OS（11.5 个月比 6.3 个月）。PD-L1 阳性肿瘤的 OS 更高（9.9 个月比 6.5 个月）。此外，免疫疗法比标准疗法引起的不良反应更少。
我们的结果表明免疫疗法可提高 HNSCC 患者的 RR 和 OS，HPV 和 PD-L1 阳性肿瘤患者的获益更高。
