Efficacy of first-line immune checkpoint inhibitors for recurrent/metastatic head and neck cancer: a systematic review and meta-analysis.

IF 2.3 4区医学 Q3 IMMUNOLOGY

Immunotherapy Pub Date : 2026-02-01 Epub Date: 2026-04-14 DOI:10.1080/1750743X.2026.2643939

Jiuli Zhou, Wenbo Tang, Liqiong Xue

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引用次数: 0

Abstract

Introduction: Immune checkpoint inhibitors (ICIs) have brought a paradigm shift in recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC), but their first-line efficacy remains inconsistent. This meta-analysis compared the efficacy of ICIs versus the EXTREME regimen in R/M HNSCC patients.

Methods: Randomized controlled trials evaluating the efficacy of ICIs versus EXTREME in R/M HNSCC patients and reporting on programmed death-ligand 1 (PD-L1) expression, overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) were included. Kaplan-Meier curves of OS and PFS were reconstructed; ORR was presented as odds ratios.

Results: From an initial pool of 356 studies, three trials were included. In the total population, median OS was similar among ICI monotherapy (11.5 months), dual ICIs (12.5 months), and EXTREME (12.0 months). In the PD-L1 high expression population, ICI monotherapy and dual ICIs demonstrated a trend toward improved OS relative to EXTREME. EXTREME demonstrated better PFS and ORR than ICI monotherapy and dual ICIs in both the total and PD-L1 high expression populations.

Conclusions: First-line ICI monotherapy and dual ICIs did not significantly improve OS, PFS, and ORR compared with EXTREME. However, a discernible trend suggested a potential survival benefit for ICIs in patients with high PD-L1 expression.

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一线免疫检查点抑制剂治疗复发/转移性头颈癌的疗效：一项系统综述和荟萃分析

免疫检查点抑制剂（ICIs）已经带来了复发/转移（R/M）头颈部鳞状细胞癌（HNSCC）的范式转变，但它们的一线疗效仍然不一致。本荟萃分析比较了ICIs方案与EXTREME方案在R/M HNSCC患者中的疗效。方法：纳入随机对照试验，评估ICIs与EXTREME在R/M HNSCC患者中的疗效，并报告程序性死亡配体1 （PD-L1）表达、总生存期（OS）、无进展生存期（PFS）和客观缓解率（ORR）。重建OS和PFS的Kaplan-Meier曲线；ORR以比值比表示。结果：从最初的356项研究中，纳入了3项试验。在总人口中，ICI单药治疗（11.5个月）、双重ICI治疗（12.5个月）和EXTREME治疗（12.0个月）的中位OS相似。在PD-L1高表达人群中，ICI单药治疗和双重ICI治疗相对于EXTREME有改善OS的趋势。在总人群和PD-L1高表达人群中，EXTREME的PFS和ORR均优于ICI单药治疗和双ICIs。结论：与EXTREME相比，一线ICI单药治疗和双ICI治疗并没有显著改善OS、PFS和ORR。然而，一个明显的趋势表明，在PD-L1高表达的患者中，ICIs有潜在的生存益处。

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

Immunotherapy 医学-免疫学

CiteScore

5.00

自引率

3.60%

发文量

113

审稿时长

6-12 weeks

期刊介绍： Many aspects of the immune system and mechanisms of immunomodulatory therapies remain to be elucidated in order to exploit fully the emerging opportunities. Those involved in the research and clinical applications of immunotherapy are challenged by the huge and intricate volumes of knowledge arising from this fast-evolving field. The journal Immunotherapy offers the scientific community an interdisciplinary forum, providing them with information on the most recent advances of various aspects of immunotherapies, in a concise format to aid navigation of this complex field. Immunotherapy delivers essential information in concise, at-a-glance article formats. Key advances in the field are reported and analyzed by international experts, providing an authoritative but accessible forum for this vitally important area of research. Unsolicited article proposals are welcomed and authors are required to comply fully with the journal''s Disclosure & Conflict of Interest Policy as well as major publishing guidelines, including ICMJE and GPP3.