Pembrolizumab plus cetuximab with neoadjuvant chemotherapy for head and neck squamous cell carcinoma.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
Zhuowei Yao, Jingshuo Wang, Yongquan Jiang, Yi Zhang, Jun Liu, Li Dai, Silin Shen, Xiang Zhou, Qiang Liu, Luying Zheng, Minfei Qian, Jiping Li
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引用次数: 0

Abstract

Purpose: Head and neck cancer cells commonly express programmed death ligand 1 (PD-L1) and epidermal growth factor receptor (EGFR), both of which play pivotal roles in the antitumor cellular immune response. Pembrolizumab, a PD-1 inhibitor, and cetuximab, an EGFR inhibitor, are typically effective agents combined with neoadjuvant platinum-based chemotherapy for the treatment of head and neck squamous cell carcinoma (HNSCC). This study aims to evaluate the efficacy and safety of neoadjuvant immunochemotherapy in patients with HNSCC.

Methods: Patients with HNSCC underwent radical surgery and complete cervical lymph node dissection following neoadjuvant immunochemotherapy at RenJi Hospital from January 2021 to June 2024 were retrospectively analyzed. The primary endpoint was major pathological response (MPR). We further explored the relationship between the efficacy and immune estimators.

Findings: Twenty-one patients were enrolled in this retrospective study. The MPR was 66.7%, including 11 patients who achieved a pathological complete response (pCR). The overall response rate (ORR) was 90.5%, and the complete response (CR) rate was 28.6%. The oropharynx, as the primary site, was the sensitive tumor type to neoadjuvant immunochemotherapy. The most common adverse event (AEs) was anemia (61.9%). No grade 4 AE or delayed surgery was reported. Laryngeal preservation rates were 90.9% (10/11), and pathological findings confirmed negative surgical margins for all patients. Moreover, pre-treatment peripheral lymphocyte count, monocyte count, and platelet to lymphocyte ratio (PLR) displayed a significant correlation with the treatment response.

Conclusion: Pembrolizumab plus cetuximab with chemotherapy for patients with HNSCC is a feasible and safe clinical protocol fulfilling organ preservation and life quality improvement. Pre-treatment peripheral immune estimators could help to screen patients who may respond to the neoadjuvant immunochemotherapy.

头颈部鳞状细胞癌的 Pembrolizumab 加西妥昔单抗新辅助化疗。
目的:头颈部癌细胞通常表达程序性死亡配体1(PD-L1)和表皮生长因子受体(EGFR),两者在抗肿瘤细胞免疫反应中发挥着关键作用。PD-1抑制剂Pembrolizumab和表皮生长因子受体抑制剂西妥昔单抗是联合新辅助铂类化疗治疗头颈部鳞状细胞癌(HNSCC)的典型有效药物。本研究旨在评估新辅助免疫化疗对HNSCC患者的疗效和安全性:方法:回顾性分析2021年1月至2024年6月期间在仁济医院接受根治术和完全颈淋巴结清扫术后新辅助免疫化疗的HNSCC患者。主要终点为主要病理反应(MPR)。我们进一步探讨了疗效与免疫估计指标之间的关系:这项回顾性研究共纳入 21 名患者。主要病理反应率为 66.7%,其中 11 名患者获得了病理完全反应(pCR)。总反应率(ORR)为 90.5%,完全反应率(CR)为 28.6%。口咽作为原发部位,是对新辅助免疫化疗敏感的肿瘤类型。最常见的不良反应是贫血(61.9%)。没有4级不良反应或手术延迟的报告。喉保留率为90.9%(10/11),病理结果证实所有患者的手术切缘均为阴性。此外,治疗前外周淋巴细胞计数、单核细胞计数和血小板与淋巴细胞比值(PLR)与治疗反应有显著相关性:Pembrolizumab联合西妥昔单抗化疗治疗HNSCC患者是一种可行且安全的临床方案,可实现器官保护和生活质量改善。治疗前外周免疫估计值有助于筛选可能对新辅助免疫化疗有反应的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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