Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China.
J Hematol Oncol. 2020 Dec 11;13(1):174. doi: 10.1186/s13045-020-01019-5.
Immunotherapy has been a new standard for recurrent/metastatic head and neck cancers (R/M HNC). One of the prominent characteristics of cancer immunotherapy is the induction of immune memory followed by endured treatment response. However, whether and how a treatment delay would impact on the efficacy of immunotherapy has not been well determined. During the outbreak of COVID-19, a number of cancer patients in Wuhan, the epicenter of the pandemic in China, had experienced long-lasting city lockdown and delay of immunotherapies. Here, we retrospectively analyzed 24 HNC patients treated with immune checkpoint inhibitors in our cancer institute prior to the outbreak of COVID-19 who were re-evaluated after the restoration of regular medical care. Of these 24 patients, 10 patients had achieved complete response (CR) or partial response (PR), 12 patients had achieved stable disease (SD), and 2 patients had received just one cycle treatment without efficacy evaluation before treatment delay. The median delay was 3.75 months (range 1.73-8.17 months). Re-evaluation after treatment delay revealed that ten patients (10/10) who achieved CR or PR, two patients (2/2) who received just one cycle treatment without efficacy evaluation and seven patients (7/12) who achieved SD before outbreak of COVID-19 maintained tumor response after treatment delay. Among the rest five patients who had achieved SD, four patients were re-evaluated as progressive disease (PD) due to treatment delay and one patient died after treatment interruption without re-evaluation. Our results from a small cohort of R/M HNC patients showed that treatment delay of three to four months might have mild, if any, impact on the efficacy of immunotherapy for patients with controlled disease.
免疫疗法一直是复发性/转移性头颈部癌症（R/M HNC）的新标准。癌症免疫疗法的一个突出特点是诱导免疫记忆，随后产生持久的治疗反应。然而，治疗延迟是否以及如何影响免疫疗法的疗效尚未得到很好的确定。在 COVID-19 爆发期间，中国疫情中心武汉的许多癌症患者经历了长时间的城市封锁和免疫治疗的延迟。在这里，我们回顾性分析了 COVID-19 爆发前在我们癌症研究所接受免疫检查点抑制剂治疗的 24 例 HNC 患者，在恢复常规医疗护理后对这些患者进行了重新评估。在这 24 名患者中，10 名患者达到完全缓解（CR）或部分缓解（PR），12 名患者达到疾病稳定（SD），2 名患者在治疗延迟前仅接受一个周期治疗且没有疗效评估。中位延迟时间为 3.75 个月（范围 1.73-8.17 个月）。治疗延迟后的重新评估显示，10 名达到 CR 或 PR 的患者（10/10）、2 名仅接受一个周期治疗且无疗效评估的患者（2/2）和 7 名在 COVID-19 爆发前达到 SD 的患者（7/12）在治疗延迟后保持肿瘤反应。在其余 5 名达到 SD 的患者中，由于治疗延迟，有 4 名患者被重新评估为进展性疾病（PD），1 名患者因治疗中断而死亡，且没有重新评估。我们从一小部分 R/M HNC 患者中获得的结果表明，对于病情得到控制的患者，三到四个月的治疗延迟可能对免疫疗法的疗效只有轻微影响（如果有的话）。
