Semrau Sabine, Gostian Antoniu-Oreste, Traxdorf Maximilian, Eckstein Markus, Rutzner Sandra, von der Grün Jens, Illmer Thomas, Hautmann Matthias, Klautke Gunther, Laban Simon, Brunner Thomas, Tamaskovics Bálint, Frey Benjamin, Zhou Jian-Guo, Geppert Carol-Immanuel, Hartmann Arndt, Balermpas Panagiotis, Budach Wilfried, Gaipl Udo, Iro Heinrich, Fietkau Rainer, Hecht Markus
Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, 91054 Bayern, Germany.
Department of Otorhinolaryngology-Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, 91054 Bayern, Germany.
Cancers (Basel). 2021 Apr 19;13(8):1959. doi: 10.3390/cancers13081959.
To determine whether a single dose of double immune checkpoint blockade (induction chemoimmunotherapy (ICIT)) adds benefit to induction single-cycle platinum doublet (induction chemotherapy (IC)) in locally advanced head and neck squamous cell carcinoma (HNSCC), patients treated with cisplatin 30 mg/m d1-3 and docetaxel 75 mg/m d1 combined with durvalumab 1500 mg fixed dose d5 and tremelimumab 75 mg fixed dose d5 (ICIT) within the CheckRad-CD8 trial were compared with a retrospective cohort receiving the same chemotherapy (IC) without immunotherapy. The endpoint of this analysis was the complete response rate (CR). A total of 53 patients were treated with ICIT and 104 patients with IC only. CR rates were 60.3% for ICIT and 40.3% for IC ( = 0.018). In the total population ( = 157), the most important predictor to achieve a CR was treatment type (OR: 2.21 for ICIT vs. IC; = 0.038, multivariate analysis). The most diverse effects in CR rates between ICIT and IC were observed in younger (age ≤ 60) patients with HPV-positive OPSCCs (82% vs. 33%, = 0.176), while there was no difference in older patients without HPV-positive OPSCCs (53% vs. 48%). The analysis provides initial evidence that ICIT could result in higher CR rates than IC. Young patients with HPV-positive OPSCCs may have the greatest benefit from additional immune checkpoint inhibitors.
为了确定单剂量双重免疫检查点阻断（诱导化疗免疫疗法（ICIT））是否能为局部晚期头颈部鳞状细胞癌（HNSCC）的诱导单周期铂类双联化疗（诱导化疗（IC））带来更多益处，在CheckRad-CD8试验中，将接受顺铂30mg/m² d1-3和多西他赛75mg/m² d1联合度伐利尤单抗1500mg固定剂量d5以及曲美木单抗75mg固定剂量d5（ICIT）治疗的患者与接受相同化疗（IC）但未进行免疫治疗的回顾性队列进行了比较。该分析的终点是完全缓解率（CR）。共有53例患者接受了ICIT治疗，104例患者仅接受了IC治疗。ICIT组的CR率为60.3%，IC组为40.3%（P = 0.018）。在总人群（n = 157）中，实现CR的最重要预测因素是治疗类型（ICIT与IC相比的OR：2.21；P = 0.038，多变量分析）。在年轻（年龄≤60岁）的HPV阳性口咽鳞状细胞癌（OPSCC）患者中，观察到ICIT和IC之间CR率的差异最大（82%对33%，P = 0.176），而在无HPV阳性OPSCC的老年患者中没有差异（53%对48%）。该分析提供了初步证据，表明ICIT可能比IC导致更高的CR率。年轻的HPV阳性OPSCC患者可能从额外的免疫检查点抑制剂中获益最大。
