PD-1 抑制剂联合紫杉醇（白蛋白结合型）和顺铂用于局部晚期喉和声门下鳞状细胞癌的喉保留：一项回顾性研究。
PD-1 Inhibitors combined with paclitaxel (Albumin-bound) and cisplatin for larynx preservation in locally advanced laryngeal and hypopharyngeal squamous cell carcinoma: a retrospective study.
机构信息
State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China.
出版信息
Cancer Immunol Immunother. 2023 Dec;72(12):4161-4168. doi: 10.1007/s00262-023-03550-z. Epub 2023 Oct 7.
BACKGROUND
laryngeal and hypopharyngeal squamous cell carcinoma (SCC) is a common head and neck cancer with significant impact on quality of life due to its crucial roles in vocalization, airway protection, and swallowing. This retrospective study aims to evaluate the efficacy and larynx organ preservation of neoadjuvant treatment with PD-1 inhibitors in combination with paclitaxel (Albumin-bound) and cisplatin for locally advanced laryngeal and hypopharyngeal SCC.
METHODS
Medical records of consecutive patients diagnosed with histologically or cytologically confirmed locally advanced SCC of the larynx and hypopharynx, who received PD-1 inhibitor therapy at a single tertiary care center, were reviewed from January 1, 2019, to December 15, 2022. The patients were treated with a combination of PD-1 inhibitors, paclitaxel (Albumin-bound) 260mg/m2, and cisplatin 60mg/m2 (TP) as their first-line therapy. Survival outcomes, laryngectomy-free survival (LFS) rates and response rates were assessed.
RESULTS
The study cohort comprised 156 patients, predominantly male, with a median age of 60.4 years. The estimated one-year overall survival (OS) rate was 94.1%, two-year OS rate was 82.5%, one-year progression-free survival (PFS) rate was 80.4%, and two-year PFS rate was 66.3%. The one-year LFS was 86.4%, and the two-year LFS rate was 73.0%. The overall response rate after TP + PD-1 inhibitors therapy was 88.5%. Common treatment-associated adverse events included rash, thyroid function abnormalities, myelosuppression, and colitis.
CONCLUSION
Neoadjuvant therapy with PD-1 inhibitors in combination with paclitaxel (Albumin-bound) and cisplatin showed promising efficacy and tolerability for larynx preservation in locally advanced laryngeal and hypopharyngeal SCC. The high response rates and favorable survival outcomes suggest this approach as a potential treatment option. Prospective randomized controlled trials are needed to further validate these findings and establish the role of immunotherapy in larynx preservation.
背景
喉和下咽鳞状细胞癌（SCC）是一种常见的头颈部癌症，由于其在发声、气道保护和吞咽方面的关键作用，对生活质量有重大影响。本回顾性研究旨在评估 PD-1 抑制剂联合紫杉醇（白蛋白结合型）和顺铂新辅助治疗局部晚期喉和下咽 SCC 的疗效和喉器官保留。
方法
回顾性分析 2019 年 1 月 1 日至 2022 年 12 月 15 日在一家三级保健中心接受 PD-1 抑制剂治疗的连续确诊为局部晚期喉和下咽 SCC 的患者的病历。患者接受 PD-1 抑制剂联合紫杉醇（白蛋白结合型）260mg/m2 和顺铂 60mg/m2（TP）作为一线治疗。评估生存结果、喉切除术无复发生存（LFS）率和反应率。
结果
研究队列包括 156 名患者，主要为男性，中位年龄为 60.4 岁。估计一年总生存率（OS）为 94.1%，两年 OS 率为 82.5%，一年无进展生存率（PFS）为 80.4%，两年 PFS 率为 66.3%。一年 LFS 为 86.4%，两年 LFS 率为 73.0%。TP+PD-1 抑制剂治疗后的总缓解率为 88.5%。常见的治疗相关不良事件包括皮疹、甲状腺功能异常、骨髓抑制和结肠炎。
结论
PD-1 抑制剂联合紫杉醇（白蛋白结合型）和顺铂的新辅助治疗对局部晚期喉和下咽 SCC 的喉保留显示出良好的疗效和耐受性。高反应率和良好的生存结果表明，这种方法可能是一种潜在的治疗选择。需要前瞻性随机对照试验进一步验证这些发现，并确定免疫疗法在喉保留中的作用。
Zotero 插件