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.
Highlights
Several prognostic factors in nivolumab therapy have been reported in recurrent or metastatic head and neck cancer (RM-HNC) patients, these factors remain controversial
We conducted a multicenter retrospective cohort study to investigate the impact of clinico-hematological factors on survival in RM-HNC patients treated with nivolumab therapy among the Japanese population
This study found the prognostic effect of clinico-hematological factors, including the occurrence of immune-related adverse events (irAEs), relative eosinophil count (REC), best overall response (BOR), Eastern Cooperative Oncology Group Performance Status (ECOG PS), and modified Glasgow Prognostic Score (mGPS) in RM-HNC patients treated with nivolumab therapy
Summary
Several prognostic factors in nivolumab therapy have been reported in recurrent or metastatic head and neck cancer (RM-HNC) patients, these factors remain controversial. 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. 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]. We conducted a multicenter retrospective cohort study to investigate the impact of clinico-hematological factors on survival in RM-HNC patients treated with nivolumab therapy among the Japanese population. Variables Age < 69 ≥ 69 Sex Male Female Primary tumor site Oral cavity Nasopharynx Oropharynx Hypopharynx Larynx Sinonasal cavity Salivary gland External ear canal Unknown ECOG PS 01 2–3 Site of recurrence Loco-regional Distant Platinum sensitivity Sensitive Refractory Modified Glasgow Prognostic Score 0 1 2 Unknown Relative eosinophil count < 1.5 ≥ 1.5 Unknown Neutrophil/lymphocyte ratio < 5 ≥ 5 Unknown Platelet/lymphocyte ratio < 253 ≥ 253 Unknown
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