Lien Ming-Yu, Wang Chih-Chun, Hwang Tzer-Zen, Hsieh Ching-Yun, Yang Chuan-Chien, Wang Chien-Chung, Lien Ching-Feng, Shih Yu-Chen, Yeh Shyh-An, Hsieh Meng-Che
Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung 40201, Taiwan.
School and Medicine, China Medical University, Taichung 40201, Taiwan.
Cancers (Basel). 2024 Apr 30;16(9):1748. doi: 10.3390/cancers16091748.
The significance of tumor burden for survival is unknown for patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). The purpose of our study was to evaluate the prognostic impact of programmed death ligand-1 (PD-L1) and tumor burden score (TBS) in patients with R/M HNSCC.
R/M HNSCC patients who were treated with cisplatin, 5-fluorouracil plus cetuximab (EPF) or pembrolizumab (PPF) as first-line treatment were included in our study. PD-L1 and TBS were estimated and correlated with treatment responses. Kaplan-Meier curves were plotted for outcomes estimation.
A total of 252 R/M HNSCC patients were included, with 126 high tumor burden (HTB) and 126 low tumor burden (LTB) patients. Median progression-free survival (PFS) was 7.1 months in LTB and 3.9 months in HTB ( < 0.001) and median overall survival (OS) was 14.2 months in LTB and 9.2 months in HTB ( = 0.001). Patients with LTB had better PFS and OS than those with HTB independent of PD-L1 status. Subgroup analysis showed HTB patients treated with EPF had better survival than those treated with PPF, regardless of PD-L1 expression. For LTB PD-L1 positive patients, there was a longer survival with PPF than EPF, while for LTB PD-L1 negative patients, survival was similar between PPF and EPF. Multivariate analysis exhibited that tumor burden was significantly correlated with OS.
Tumor burden is significantly correlated with survival in patients with R/M HNSCC. PD-L1 and TBS should be taken into consideration to determine first-line treatment.
复发性或转移性头颈部鳞状细胞癌（R/M HNSCC）患者中，肿瘤负荷对生存的意义尚不清楚。我们研究的目的是评估程序性死亡配体-1（PD-L1）和肿瘤负荷评分（TBS）对R/M HNSCC患者的预后影响。
我们的研究纳入了接受顺铂、5-氟尿嘧啶联合西妥昔单抗（EPF）或帕博利珠单抗（PPF）作为一线治疗的R/M HNSCC患者。评估了PD-L1和TBS，并将其与治疗反应相关联。绘制了Kaplan-Meier曲线以评估预后。
总共纳入了252例R/M HNSCC患者，其中126例为高肿瘤负荷（HTB）患者，126例为低肿瘤负荷（LTB）患者。LTB患者的中位无进展生存期（PFS）为7.1个月，HTB患者为3.9个月（<0.001），中位总生存期（OS）在LTB患者中为14.2个月，HTB患者中为9.2个月（=0.001）。无论PD-L1状态如何，LTB患者的PFS和OS均优于HTB患者。亚组分析显示，接受EPF治疗的HTB患者比接受PPF治疗的患者生存更好，无论PD-L1表达如何。对于LTB PD-L1阳性患者，PPF治疗的生存期比EPF更长，而对于LTB PD-L1阴性患者，PPF和EPF之间的生存期相似。多变量分析显示肿瘤负荷与OS显著相关。
肿瘤负荷与R/M HNSCC患者的生存显著相关。在确定一线治疗时应考虑PD-L1和TBS。
