Role of PD-1/PD-L1 inhibitors in the treatment of recurrent/metastatic head and neck squamous cell carcinoma: A systematic review and meta-analysis

Clin Otolaryngol. 2021 Sep;46(5):1013-1020. doi: 10.1111/coa.13772. Epub 2021 Apr 21.

Abstract

Background: The use of immunotherapy to treat recurrent/metastatic squamous cell carcinoma of the head and neck has become a popular research topic in recent years, and many clinical trials have been carried out.

Objectives: To systematically evaluate the efficacy and safety of PD-1/PD-L1 inhibitors in the treatment of recurrent/metastatic head and neck squamous cell carcinoma.

Methods: We searched PubMed, Embase, Cochrane Library and other databases up to 1 November 2019 for publications reporting the use of PD-1/PD-L1 inhibitors in the treatment of squamous cell carcinoma of the head and neck. Revman 5.0 was used for combination analysis, and the overall survival (OS), progression-free survival (PFS), overall response rate (ORR) and adverse events were determined.

Results: Five articles were included. Compared with other treatment methods, this meta-analysis showed that treatment with PD-1/PD-L1 inhibitors can significantly improve OS (P < .0001), but there was no significant improvement in PFS or ORR. The risk of anaemia and nausea was significantly reduced by treatment with PD-1/PD-L1 inhibitors.

Conclusions and significance: Treatment with PD-1/PD-L1 inhibitors alone can improve the overall survival rate for recurrent/metastatic squamous cell carcinoma of the head and neck but there is no obvious advantage in other aspects and adverse events.

Keywords: HNSCC; PD-1/PD-L1 inhibitors; meta-analysis; systematic review.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Antineoplastic Agents, Immunological / therapeutic use*
  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use*
  • Neoplasm Recurrence, Local / drug therapy*
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors*
  • Randomized Controlled Trials as Topic
  • Squamous Cell Carcinoma of Head and Neck / drug therapy*
  • Survival Analysis

Substances

  • Antineoplastic Agents, Immunological
  • Immune Checkpoint Inhibitors
  • Programmed Cell Death 1 Receptor