Prognostic Impact of Sarcopenia on Clinical Outcomes in Patients With Recurrent and/or Metastatic Head and Neck Squamous Cell Carcinoma Treated With Immune Checkpoint Inhibitors.

BACKGROUND/AIM: Poor nutritional status is one of the key contributing factors to sarcopenia, which negatively influences postoperative complications and clinical outcomes in patients with head and neck squamous cell carcinoma (HNSCC). This study aimed to investigate the potential association between sarcopenia and clinical outcomes in patients with recurrent and/or metastatic HNSCC treated with immune checkpoint inhibitors (ICIs).

PATIENTS AND METHODS

A retrospective review was conducted on the medical records of 119 patients with recurrent and/or metastatic HNSCC who received ICI therapy.

RESULTS

The objective response rates (ORRs) were 30.7% in the non-sarcopenia group and 15.8% in the sarcopenia group, showing a statistically significant difference between the two groups (=0.048). Patients with good performance status (PS), absence of sarcopenia, and distant metastasis exhibited significantly longer overall survival (OS) compared to those with poor PS, sarcopenia, and locoregional recurrence, respectively (=0.014, =0.003, =0.026). Multivariate analysis identified sarcopenia and locoregional recurrence as independent prognostic factors for OS. The incidence of immune-related adverse events (irAEs) did not significantly differ between patients with and without sarcopenia.

CONCLUSION

These findings underscore the detrimental impact of sarcopenia on the efficacy of immune checkpoint inhibitor therapy in patients with recurrent and/or metastatic HNSCC. Careful consideration of sarcopenia is warranted in the clinical management of these patients.