在头颈部鳞癌肿瘤复发或转移患者中，免疫检查点抑制剂后的化疗：临床有效性及炎症和营养因素的影响。
Chemotherapy following immune checkpoint inhibitors in recurrent or metastatic head and neck squamous cell carcinoma: clinical effectiveness and influence of inflammatory and nutritional factors.
发表日期：2023 Aug 29
作者：
Akihiro Sakai, Koji Ebisumoto, Hiroaki Iijima, Mayu Yamauchi, Takanobu Teramura, Aritomo Yamazaki, Takane Watanabe, Toshihide Inagi, Daisuke Maki, Kenji Okami
来源：
Immunity & Ageing
摘要：
本研究旨在评估免疫检查点抑制剂（ICI）后化疗的临床疗效。还研究了炎症和营养因素与预后的关联。我们回顾性地审查了接受ICI治疗后接受化疗的复发或转移性头颈鳞状细胞癌（RMHNSCC）患者的病历。检查了化疗后的反应率和生存情况，以及营养和炎症因素。在化疗前的ICI治疗中，36名患者（70.6%）接受奈伏莫单抗（nivolumab），15名患者（29.4%）接受帕博利珠单抗（pembrolizumab）。化疗方案包括PTX（32例，62.7%）、PTX+Cmab（9例，17.6%）和S1（10例，19.6%）。中位总生存期（OS）为20个月（95% CI 12-25），12个月OS率估计为63.3%，中位无进展生存期（PFS）为5个月（CI 4-6），12个月PFS估计为8.9%。单变量分析显示，中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）、控制营养状况评分（CONUT）和预后营养指数（PNI）与OS和PFS显著相关。此外，这些因素在对数秩检验中与OS和PFS显著相关。ICI后的化疗具有高度有效性。化疗方案之间没有显著差异。炎症和营养因素可能与化疗后患者的预后相关。© 2023. Springer Science+Business Media, LLC.
This study aimed to evaluate the clinical effectiveness of chemotherapy following immune checkpoint inhibitors (ICI). The association between inflammatory and nutritional factors and prognosis has also been investigated.We retrospectively reviewed the medical records of recurrent or metastatic head and neck squamous cell carcinoma (RMHNSCC) patients who received chemotherapy following ICI therapy. The response rate and survival after chemotherapy, and nutritional and inflammatory factors, were examined.The ICI before chemotherapy was nivolumab in 36 patients (70.6%) and pembrolizumab in 15 patients (29.4%). The chemotherapy regimens consisted of PTX in 32 patients (62.7%), PTX + Cmab in 9 (17.6%), and S1 in 10 (19.6%). The median overall survival (OS) was 20 months (95% CI 12-25), the estimated 12-month OS rate was 63.3%, the median progression-free survival (PFS) was 5 months (CI 4-6), and the 12-month PFS estimate was 8.9%. Univariate analysis significantly correlated Neutrophil-to-Lymphocyte Ratio (NLR), platelet-to-lymphocyte ratio (PLR), controlling nutritional status score (CONUT), and prognostic nutrition index (PNI) with OS and PFS. Additionally, these factors were significantly correlated with OS and PFS in the log-rank tests.Chemotherapy following ICI is highly effective. There were no significant differences in the chemotherapy regimens. Inflammatory and nutritional factors may associate with patient prognosis after chemotherapy.© 2023. Springer Science+Business Media, LLC.