Induction chemotherapy combined with immunotherapy in locally advanced head and neck squamous cell carcinoma

Abstract

Background This study aimed to explore the efficacy and safety of sintilimab combined with induction chemotherapy (IC) in locally advanced head and neck squamous cell carcinoma (HNSCC) patients. Methods A total of 163 patients were prospectively enrolled; 98 patients received IC only, and 65 patients received IC with sintilimab. Following neoadjuvant therapy, patients either underwent surgery (31.9%) or chemoradiotherapy (68.1%). Objective response rate (ORR), progression free survival (PFS), overall survival (OS), and toxicities between the two groups were compared. Results The ORR in the IC group was significantly lower than that in the IC with sintilimab group (68.4% vs 84.6%, P = 0.019). Grade 3 or higher acute toxicity occurred in 15 (15.3%) and 12 (18.5%) patients in the IC and IC with sintilimab groups, respectively. However, this difference was not significant (P = 0.596). After follow-up with a median time of 28.0 months, the IC group had a 2-year PFS rate of 27% (95%CI: 18–36%), whereas the IC with sintilimab group had a 2-year PFS rate of 44% (95%CI: 32–56%), and this difference was significant (P = 0.041). The 2-year OS rates in the IC and IC with sintilimab groups were 61% (95%CI: 52–70%) and 70% (95%CI: 60–80%), respectively, the difference was not significant (P = 0.681). Conclusions Addition of sintilimab to IC could provide longer PFS time than traditional chemotherapy regimen, without increasing the toxicity events.

Immunotherapy in Head and Neck Cancer When, How, and Why?

“…To evaluate the efficacy and safety of an anti-PD-1 agent (Sintilimab) combined with induction chemotherapy (IC), Li et al [ 63 ] developed a study involving 163 patients with locally advanced and untreated HNSCC ( Table 2 ). After evaluation of the expression of PD-L1 and P16, it is known that 28.6% (n = 16) of patients with oropharynx cancer (OPC) are HPV-positive.…”

Feasibility of Apatinib in Radioiodine-Refractory Differentiated Thyroid Carcinoma

“…PFS was calculated from the date of initial treatment to the date of disease progression or death from any cause. OS was calculated from the date of initial treatment to the date of the last follow-up or death from any cause ( 13 ). The third endpoint was the rate of adverse reactions, which were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.0) ( 14 ).…”

High Risk-Human Papillomavirus in HNSCC: Present and Future Challenges for Epigenetic Therapies

“…Interestingly pre-clinical data are demonstrating that targeting epigenetic regulators, both broad and targeted reprogrammers such as DNMTs, HDACs, EZH2, LSD1 and KDM4A, leads to the activation of immune response pathways and boosts the anti-tumor immune response, suggesting that combining immune check-point inhibitors with specific epi-drugs could be a novel valuable promising therapeutic option to be studied and considered for HNSCC treatment [ 20 , 114 , 115 ]. To date in HNSCC significant disease benefits have been observed combining ICIs, as pembrolizumab, with chemotherapy and several preclinical studies and clinical trials are under evaluation to assess different combinatorial therapeutic strategies, also with epi-drugs [ 13 , 20 , 115 , 116 , 117 , 118 , 119 ]. Many other immune-based therapeutic approaches are in clinical trials as well as novel strategies aimed at targeting specifically the E6 and E7 oncoproteins [ 119 ].…”