Sakai Akihiro, Ebisumoto Koji, Iijima Hiroaki, Yamauchi Mayu, Teramura Takanobu, Yamazaki Aritomo, Watanabe Takane, Inagi Toshihide, Maki Daisuke, Okami Kenji
Department of Otolaryngology, Head and Neck Surgery, Tokai University, School of Medicine, Isehara, Japan.
Discov Oncol. 2023 Aug 29;14(1):158. doi: 10.1007/s12672-023-00774-4.
This study aimed to evaluate the clinical effectiveness of chemotherapy following immune checkpoint inhibitors (ICI). The association between inflammatory and nutritional factors and prognosis has also been investigated.
We retrospectively reviewed the medical records of recurrent or metastatic head and neck squamous cell carcinoma (RMHNSCC) patients who received chemotherapy following ICI therapy. The response rate and survival after chemotherapy, and nutritional and inflammatory factors, were examined.
The ICI before chemotherapy was nivolumab in 36 patients (70.6%) and pembrolizumab in 15 patients (29.4%). The chemotherapy regimens consisted of PTX in 32 patients (62.7%), PTX + Cmab in 9 (17.6%), and S1 in 10 (19.6%). The median overall survival (OS) was 20 months (95% CI 12-25), the estimated 12-month OS rate was 63.3%, the median progression-free survival (PFS) was 5 months (CI 4-6), and the 12-month PFS estimate was 8.9%. Univariate analysis significantly correlated Neutrophil-to-Lymphocyte Ratio (NLR), platelet-to-lymphocyte ratio (PLR), controlling nutritional status score (CONUT), and prognostic nutrition index (PNI) with OS and PFS. Additionally, these factors were significantly correlated with OS and PFS in the log-rank tests.
Chemotherapy following ICI is highly effective. There were no significant differences in the chemotherapy regimens. Inflammatory and nutritional factors may associate with patient prognosis after chemotherapy.
本研究旨在评估免疫检查点抑制剂（ICI）治疗后进行化疗的临床疗效。同时也研究了炎症和营养因素与预后之间的关联。
我们回顾性分析了接受ICI治疗后进行化疗的复发性或转移性头颈部鳞状细胞癌（RMHNSCC）患者的病历。检查了化疗后的缓解率和生存率，以及营养和炎症因素。
化疗前使用的ICI中，纳武利尤单抗用于36例患者（70.6%），帕博利珠单抗用于15例患者（29.4%）。化疗方案包括32例患者使用紫杉醇（PTX，62.7%），9例患者使用PTX + 西妥昔单抗（Cmab，17.6%），10例患者使用S-1（19.6%）。中位总生存期（OS）为20个月（95%CI 12 - 25），估计12个月总生存率为63.3%，中位无进展生存期（PFS）为5个月（CI 4 - 6），12个月无进展生存率估计为8.9%。单因素分析显示中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、控制营养状况评分（CONUT）和预后营养指数（PNI）与OS和PFS显著相关。此外，在对数秩检验中，这些因素与OS和PFS也显著相关。
ICI治疗后进行化疗疗效显著。化疗方案之间无显著差异。炎症和营养因素可能与化疗后患者的预后相关。
