Matsuo Mioko, Masuda Muneyuki, Yamauchi Moriyasu, Hashimoto Kazuki, Kogo Ryunosuke, Sato Masanobu, Masuda Shogo, Nakagawa Takashi
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Department of Head and Neck Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan.
Cancers (Basel). 2024 Jul 12;16(14):2527. doi: 10.3390/cancers16142527.
The optimal timing for actively discontinuing immune checkpoint inhibitor therapy in long-term responders with recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) remains unresolved. We conducted a retrospective study of 246 patients with R/M HNSCC treated with nivolumab to determine the optimal timing to actively discontinue nivolumab therapy. We examined the point at which progression-free survival (PFS) plateaued in all cases. We compared the prognosis of 19 (7.7%) ongoing cases and 227 (92.3%) discontinued cases and analyzed treatment duration and treatment-free interval (TFI). The 6-year overall survival was 11.8% (median, 12.1), and the 6-year PFS was 15.3% (median, 3.0). The PFS curve remained stable for 3 years. The median duration of nivolumab treatment was 2.9 months (range 0.03-81.9): Ongoing group, 41.8 (5.6-81.9); Decision group, 36.8 (4.0-70.1); Toxicity group, 30.6 (2.8-64.8); and progressive disease group, 2.0 (0.03-42.9). TFI in the Decision group was 15.1 months (0.6-61.6) and 30.6 months (2.8-64.8) in the Toxicity group. Long-term responses in R/M HNSCC patients treated with nivolumab are rare but gradually increasing. For this patient group, our best estimate of the optimal time to end treatment is 3 years, as the PFS in this study reached a plateau at that timepoint.
在复发/转移性头颈部鳞状细胞癌（R/M HNSCC）的长期缓解患者中，主动停用免疫检查点抑制剂治疗的最佳时机仍未明确。我们对246例接受纳武利尤单抗治疗的R/M HNSCC患者进行了一项回顾性研究，以确定主动停用纳武利尤单抗治疗的最佳时机。我们检查了所有病例中无进展生存期（PFS）达到平台期的时间点。我们比较了19例（7.7%）持续治疗病例和227例（92.3%）停药病例的预后，并分析了治疗持续时间和无治疗间隔（TFI）。6年总生存率为11.8%（中位数，12.1），6年PFS为15.3%（中位数，3.0）。PFS曲线在3年内保持稳定。纳武利尤单抗治疗的中位持续时间为2.9个月（范围0.03 - 81.9）：持续治疗组为41.8（5.6 - 81.9）；决策组为36.8（4.0 - 70.1）；毒性组为30.6（2.8 - 64.8）；疾病进展组为2.0（0.03 - 42.9）。决策组的TFI为15.1个月（0.6 - 61.6），毒性组为30.6个月（2.8 - 64.8）。接受纳武利尤单抗治疗的R/M HNSCC患者的长期缓解很少见，但逐渐增加。对于该患者群体，我们对最佳治疗结束时间的最佳估计是3年，因为本研究中的PFS在该时间点达到了平台期。
