Inflammation and malnutrition as markers of poor outcomes in head and neck cancer patients treated with nivolumab

Abstract

Background Although immune checkpoint inhibitors (ICIs) are approved for the treatment of recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC), the response to ICIs remains unclear. Aims/objectives To summarize the clinical outcomes of patients with HNSCC treated with nivolumab (Nivo) in our institution, and provide a basis for research on biomarkers that can predict the efficacy of ICIs. Material and methods Forty-four patients with R/M HNSCC who received Nivo (2017–2022) were retrospectively analysed. Results Despite the older age of this cohort (median age of 72 years), we observed favourable long-term outcomes, with an overall survival of 24.1 months, which could be attributed to our aggressive nutritional intervention. Older age, poor performance status (≥1), and higher Glasgow Prognostic Scores, reflecting the chronic inflammation and malnutrition of patients, were associated with poor prognoses, with hazard ratios for death of 2.63 (95% confidence interval [CI]; 1.07–6.46, p = .016), 3.50 (95% CI; 1.28–9.55, p = .001), and 2.69 (95% CI; 1.17–6.21, p = .029), respectively. Peripheral blood biomarker analysis revealed that systemic inflammation may negatively affect the efficacy of Nivo. Conclusions and significance Our results suggest that nutrition and inflammation must be the focus of future studies aiming to identify novel biomarkers.