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Meta-Analysis
. 2020 Jun:150:102966.
doi: 10.1016/j.critrevonc.2020.102966. Epub 2020 Apr 22.

Immunotherapy improves efficacy and safety of patients with HPV positive and negative head and neck cancer: A systematic review and meta-analysis

Marisol Miranda Galvis  1 , Gabriel Alvares Borges  2 , Thiago Bueno de Oliveira  3 , Isabela Porto de Toledo  4 , Rogerio Moraes Castilho  5 , Eliete Neves Silva Guerra  2 , Luiz Paulo Kowalski  6 , Cristiane Helena Squarize  7
Affiliations
Meta-Analysis

Immunotherapy improves efficacy and safety of patients with HPV positive and negative head and neck cancer: A systematic review and meta-analysis

Marisol Miranda Galvis et al. Crit Rev Oncol Hematol. 2020 Jun.

Abstract

Background: Despite multiple modalities used to management of head and neck squamous cell carcinoma (HNSCC), disease control remains unsatisfactory. Immunotherapy is emerging as a novel therapeutic approach. This systematic review assesses clinical data regarding immunotherapy efficacy and safety.

Methods: Data from 11 clinical trials testing immunotherapy in HNSCC were assessed. We performed the meta-analysis to correlate the overall survival (OS), response rate (RR), adverse effects, HPV status, and PD-L1 expression.

Results: Immunotherapy extended OS (hazard ratio = 0.77, p < 0.0001) and RR significantly (risk ratio = 1.41, p = 0.02). Patients with HPV-positive HNSCC exhibited a better RR (risk ratio = 1.29, p = 0.24) and OS (11.5 vs. 6.3 months). PD-L1 positive tumors showed a higher OS (9.9 vs. 6.5 months). Moreover, immunotherapy caused less adverse effects than standard therapy.

Conclusion: Our results indicate the benefit of immunotherapy for improving RR and OS of HNSCC patients. The benefit is higher in patients with HPV and PD-L1 positive tumors.

Keywords: Head and neck squamous cell carcinoma; Human papillomavirus; Immunotherapy; Meta-analysis; Programmed death-ligand 1; Toxicity.

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Conflict of interest statement

Declaration of Competing Interest The authors (M.M.G, G.A.B, I.P.T, R.M.C, E.N.S.G, L.P.K, and C.H.S) declare no commercial or financial conflict of interest. The co-author T.B.O is a consultant (advisory board) for Bristol Myers Squibb (BMS), Merck Sharp Dohme (MSD) and Merck Serono (MS). BMS, MSD and MS had no role in study design, data collection, analysis, preparation and decision to publish this systematic review and metanalysis.

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