免疫检查点抑制剂治疗头颈部鳞状细胞癌后疾病进展的危险因素

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2025-01-21 DOI:10.1002/hed.28071

Seo Yoon Jang, Yun-Gyoo Lee, Sang Hoon Chun, Ji Hyun Park, Keon Uk Park, Hyun Chang, Keun-Wook Lee, Hye Ryun Kim, Seong Hoon Shin, Ho Jung An, Kyoung Eun Lee, In Gyu Hwang, Myung-Ju Ahn, Sung-Bae Kim, Bhumsuk Keam

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引用次数: 0

摘要

背景：本研究分析了复发或转移性（R/M）头颈部鳞状细胞癌（HNSCC）患者在免疫检查点抑制剂（ICI）治疗后发展为进展性疾病（PD）的临床特征。方法：我们回顾性分析了11个医疗中心256例接受ICIs治疗的R/M型HNSCC患者。分析了治疗结果（最佳反应、总生存期和无进展生存期）与各种临床因素之间的关系。结果：客观有效率为19.5%，PD发生率为50.4%。中性粒细胞与淋巴细胞比值高(NLR bb0 4；HR, 2.20[1.28-3.78])，肿瘤大小较大(靶病变总和> 40 mm；HR, 1.74[1.03-2.94])是PD的显著危险因素。NLR高（HR, 2.00[1.42-2.82]），运动状态差(ECOG PS 2-3；HR, 3.51[2.04-6.05])，肿瘤大小较大(HR。1.63[1.19-2.24])与总生存率差独立相关。结论：高NLR和肿瘤大的患者在ICI治疗中发生PD的风险较高。

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Risk Factors for Progressive Disease After Immune Checkpoint Inhibitor Therapy in Head and Neck Squamous Cell Carcinoma.

Background: This study analyzed the clinical features of patients with recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC), who developed progressive disease (PD) after immune checkpoint inhibitor (ICI) therapy.

Methods: We retrospectively analyzed 256 patients with R/M HNSCC treated with ICIs at 11 medical centers. Associations between the treatment outcomes-best response, overall survival, and progression-free survival-and various clinical factors were analyzed.

Results: The objective response rate was 19.5% and PD was observed in 50.4% of the patients. A high neutrophil-to-lymphocyte ratio (NLR > 4; HR, 2.20 [1.28-3.78]) and large tumor size (sum of the target lesions > 40 mm; HR, 1.74 [1.03-2.94]) were significant risk factors for PD. High NLR (HR, 2.00 [1.42-2.82]), poor performance status (ECOG PS 2-3; HR, 3.51 [2.04-6.05]), and large tumor size (HR. 1.63 [1.19-2.24]) were independently associated with poor overall survival.

Conclusions: Patients with high NLR and large tumor size are at higher risk of PD during ICI therapy.

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.