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

Abstract

Although several prognostic factors in nivolumab therapy have been reported in recurrent or metastatic head and neck cancer (RM-HNC) patients, these factors remain controversial. Here, we conducted a multicenter retrospective cohort study to investigate the impact of clinico-hematological factors on survival in RM-HNC patients treated with nivolumab. We reviewed 126 RM-HNC patients from seven institutes. We evaluated the prognostic effects of clinico-hematological factors on survival. The median overall survival (OS) was 12.3 months, and the 1 year-OS rate was 51.2%. Patients without immune-related adverse events, lower relative eosinophil count, worse best overall response, higher performance status, and higher modified Glasgow Prognostic Score had worse survival. The score, generated by combining these factors, was associated with survival. Patients with score of 4–5 had worse survival than those with score of 2–3 and 0–1 [adjusted HR for PFS: score of 4–5, 7.77 (3.98–15.15); score of 2–3, 3.44 (1.95–6.06), compared to score of 0–1], [adjusted HR for OS: score of 4–5, 14.66 (4.28–50.22); score of 2–3, 7.63 (2.29–25.37), compared to score of 0–1]. Our novel prognostic score utilizing clinico-hematological factors might be useful to establish an individual treatment strategy in RM-HNC patients treated with nivolumab therapy.

The Association between a Decrease in On-Treatment Neutrophil-to-Eosinophil Ratio (NER) at Week 6 after Ipilimumab Plus Nivolumab Initiation and Improved Clinical Outcomes in Metastatic Renal Cell Carcinoma

“…Furthermore, there is growing evidence among pre-clinical studies suggesting that eosinophils are essential cells in the TME for the anti-tumor activity observed with IO [ 15 , 16 ]. Recent clinical studies also reported that a higher baseline eosinophil count was predictive of improved ICI responses in melanoma [ 17 , 18 ], urothelial cancer [ 19 ], and head and neck cancer [ 20 ]. Besides the predictive value of the baseline eosinophil count, the interval increase in eosinophil count after initiation of ICIs was also observed among responders in lung cancer [ 21 , 22 ], melanoma [ 23 ], and kidney cancer [ 24 ].…”

Utility of modified Glasgow prognostic score for head and neck squamous cell carcinoma: Systematic review and meta‐analysis

“…Nine studies (1154 cases) included people of Asian ethnicity, and two studies (863 cases) were included people of non‐Asian ethnicities. Regarding tumor location, two studies included 221 patients with hypopharyngeal cancer, 14,22 two enrolled 859 patients with oral cavity cancer, 13,23 and seven enrolled 937 patients with mixed tumor locations (more than 1 tumor location was considered in the study) 12,24–29 . Of the 11 studies, 5 involved patients with a mixed TNM stage (I‐IV), 3 involved patients who underwent nivolumab as palliative treatment for recurrent/metastatic HNSCC, and 2 included only patients with an advanced TNM stage (III‐IV).…”

“…Regarding tumor location, two studies included 221 patients with hypopharyngeal cancer, 14,22 two enrolled 859 patients with oral cavity cancer, 13,23 and seven enrolled 937 patients with mixed tumor locations (more than 1 tumor location was considered in the study). 12,[24][25][26][27][28][29] Of the 11 studies, 5 involved patients with a mixed TNM stage (I-IV), 3 involved patients who underwent nivolumab as palliative treatment for recurrent/metastatic HNSCC, and 2 included only patients with an advanced TNM stage (III-IV). All studies recorded pretreatment mGPS data, and the adjusted HRs for survival outcomes, including DFS, OS, DSS, and PFS, were directly retrieved from the included studies.…”

Elevated eosinophils as predictor of immune-related adverse events after ipilimumab and nivolumab treatment of advanced and metastatic renal cell carcinoma

“…A recent study showed that upregulation of the eosinophil count in the peripheral blood is linked with a better prognosis and response to ICI therapy. In patients with recurrent or metastatic head and neck squamous cell carcinoma treated with nivolumab, a higher eosinophil count was associated with better survival [17][18][19] . The eosinophil count positively correlated with overall survival in patients with melanoma treated with ipilimumab 20 .…”