Real-world Experience With Pembrolizumab for Advanced-stage Head and Neck Cancer Patients: A Retrospective, Multicenter Study
Real-world Experience With Pembrolizumab for Advanced-stage Head and Neck Cancer Patients: A Retrospective, Multicenter Study
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DOI：
10.21873/anticanres.15854
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发表时间：
2022-07-01
影响因子：
2
通讯作者：
NAKAGAWA, T. A. K. A. S. H., I
中科院分区：
文献类型：
--
作者：
NAKANO, T. A. K. A. F. U. M., I;YASUMATSU, R. Y. U. J., I;NAKAGAWA, T. A. K. A. S. H., I
背景/目的：本研究在现实环境中调查了派姆单抗联合或不联合化疗对晚期头颈癌 (HNC)（包括鼻咽癌、鼻窦癌和外耳道癌）的有效性。患者和方法：我们回顾性收集了 97 名仅接受派姆单抗 (n=60) 或化疗 (n=37) 治疗的 HNC 患者的数据，并研究了临床病理学结果与治疗反应或预后之间的关联。结果：接受派姆单抗联合化疗的患者的 1 年总生存率 (OS) 为 72.8%，客观缓解率 (ORR) 为 48.6%，严重 (>= G3) 不良事件 (AE) 为 29.7%。单独接受派姆单抗治疗的患者的 1 年 OS 为 51.9%，ORR 为 21.7%，>= G3 AE 为 6.7%。派姆单抗联合化疗组的 ORR 和疾病控制率 (DCR) 均显着优于派姆单抗组（分别为 p=0.074 和 p=0.00101）。在远处转移的患者中，使用派姆单抗联合化疗的患者比单独使用派姆单抗的患者获得了显着更好的 OS (p=0.0039)。在派姆单抗组的患者中，AE 阳性和更好的体能状态均与更长的 OS 相关（分别为 p=0.011 和 p=0.0037）。结论：我们的实际经验增强了派姆单抗对 HNC 患者的持久性和有效性。此外，我们的结果表明，对于有远处转移且既往未接受治疗的患者，可能会推荐使用派姆单抗联合化疗。需要进一步研究来确定 HNC 的最佳治疗策略。
Background/Aim: This study investigated the effectiveness of pembrolizumab with or without chemotherapy on advanced-stage head and neck cancer (HNC), including nasopharyngeal, sinonasal cavity and external auditory canal cancer, in a real-world setting. Patients and Methods: We retrospectively collected data from 97 HNC patients who were treated with pembrolizumab alone (n=60) or with chemotherapy (n=37), and we investigated the association between clinicopathological findings and treatment response or prognosis. Results: Patients treated with pembrolizumab and chemotherapy had a 1-year overall survival (OS) of 72.8%, objective response rate (ORR) of 48.6%, and serious (>= G3) adverse events (AEs) of 29.7%. Patients treated with pembrolizumab alone had a 1-year OS of 51.9%, ORR of 21.7%, and >= G3 AEs of 6.7%. Both the ORR and disease control rate (DCR) in the pembrolizumab with chemotherapy group were significantly better than those in the pembrolizumab group (p=0.074 and p=0.00101, respectively). Among patients with distant metastasis, patients on pembrolizumab with chemotherapy achieved significantly better OS than pembrolizumab alone (p=0.0039). Among patients in the pembrolizumab group, both AE-positive and better performance status were associated with longer OS (p=0.011 and p=0.0037, respectively). Conclusion: Our real -world experience reinforces the durability and effectiveness of pembrolizumab for HNC patients. Additionally, our results suggest that pembrolizumab with chemotherapy might be recommended for patients with distant metastasis and no prior treatment. Further studies are needed to determine the optimal treatment strategy for HNC.