Eosinophil prognostic scores for patients with head and neck squamous cell carcinoma treated with nivolumab

Abstract

Although nivolumab, a programmed cell death 1 (PD-1) inhibitor, is a standard therapy for platinum-refractory recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC), no definitive biomarkers have been reported thus far. This study aimed to select promising prognostic markers in nivolumab therapy and to create a novel prognostic scoring system. In this retrospective cohort study, we reviewed patients with R/M HNSCC who were treated with nivolumab from April 2017 to April 2019. We developed a prognostic score for immune checkpoint inhibitor (ICI) therapy that was weighed using hazard ratio-based scoring algorithms. Significant variables were selected from the multivariate Cox proportional hazard analyses on overall survival (OS). A total of 85 patients with HNSCC were analyzed in the present study. The relative eosinophil count (REC), the ratio of eosinophil increase (REI), and Eastern Cooperative Oncology Group Performance Status (ECOG PS) were selected as variables affecting the prognostic score. The patients were divided into four groups: very good (score = 0), good (score = 1), intermediate (score = 2), and poor (score = 3). The OS hazard ratios were 2.77, 10.18, and 33.21 for the good, intermediate, and poor risk groups compared with the very good risk group, respectively. The Eosinophil Prognostic Score is a novel prognostic score that is effective for predicting the prognosis of HNSCC patients treated with nivolumab. This score is more precise as it includes changes in biomarkers before and after the treatment. K E Y W O R D S eosinophils, head and neck squamous cell carcinoma, immunotherapy, nivolumab, prognostic factors This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Novel Prognostic Score for Recurrent or Metastatic Head and Neck Cancer Patients treated with Nivolumab: Japanese Multi-Institutional Cohort Study

“…Consistent with our results, Nishikawa et al demonstrated that higher eosinophil counts and increases were associated with better survival 13,18 . Furthermore, eosinophil accumulation was associated with better survival in patients with melanoma treated with ICI 19 .…”

“…To date, several studies have reported the association of patient-related factors, including the best overall response (BOR), the occurrence of immune-related adverse events (irAEs), programmed death-ligand 1 (PD-L1) expression, high mutational burden, hematological in ammatory, and nutritional markers, and clinical outcomes in RM-HNC patients treated with nivolumab therapy [5][6][7][8][9][10][11][12][13] . However, the optimal prognostic factors for nivolumab therapy in patients with RM-HNC are controversial.…”

Novel Prognostic Score for recurrent or metastatic head and neck cancer patients treated with Nivolumab

“…Nivolumab, a programmed cell death 1 (PD-1) inhibitor, was approved in 2017 to treat platinum-refractory recurrent or metastatic head and neck cancer (RM-HNC) in Japan, receiving the results of CheckMate 141 trial 1 . Although nivolumab is highly effective in some patients, more than half of these patients do not have clinical benefits.To date, several studies have reported the association of patient-related factors, including the best overall response (BOR), the occurrence of immune-related adverse events (irAEs), programmed death-ligand 1 (PD-L1) expression, high mutational burden, hematological inflammatory, and nutritional markers, and clinical outcomes in RM-HNC patients treated with nivolumab therapy [5][6][7][8][9][10][11][12][13] . Although several studies reported the utility of the combination of these factors in ICIs therapy, we found only one study in head and neck caner [13][14][15][16][17] .…”

“…To date, several studies have reported the association of patient-related factors, including the best overall response (BOR), the occurrence of immune-related adverse events (irAEs), programmed death-ligand 1 (PD-L1) expression, high mutational burden, hematological inflammatory, and nutritional markers, and clinical outcomes in RM-HNC patients treated with nivolumab therapy [5][6][7][8][9][10][11][12][13] . Although several studies reported the utility of the combination of these factors in ICIs therapy, we found only one study in head and neck caner [13][14][15][16][17] . Therefore, the optimal prognostic factors for nivolumab therapy in patients with RM-HNC are still controversial.…”

Heterogeneity of Response and Immune System Activity during Treatment with Nivolumab in Hepatocellular Carcinoma: Results from a Single-Institution Retrospective Analysis

“…Our study reports, for the first time, the prognostic role of this peripheral cells in advanced HCC patients treated with IT. The prognostic role of eosinophils in patients treated with IT was already described in other neoplasms [50][51][52]. Evidence exists that the TME can be regulated by eosinophils and neutrophils [52,53], possibly underlying their prognostic role in patients treated with IT.…”