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Meta-Analysis
. 2020 Nov 3;21(21):8229.
doi: 10.3390/ijms21218229.

Circulating Tumour Cell Expression of Immune Markers as Prognostic and Therapeutic Biomarkers in Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

Karl Payne  1 , Matthew Pugh  2 , Jill Brooks  1 , Nikolaos Batis  1 , Graham Taylor  2 , Paul Nankivell  1 , Hisham Mehanna  1
Affiliations
Meta-Analysis

Circulating Tumour Cell Expression of Immune Markers as Prognostic and Therapeutic Biomarkers in Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

Karl Payne et al. Int J Mol Sci. .

Abstract

Rates of loco-regional recurrence and distant metastasis remain high among head and neck squamous cell carcinoma (HNSCC) patients, despite advancing cancer treatment modalities and therapeutic agents. One area that has generated considerable interest is the immune landscape of the tumour, heralding a wave of immune checkpoint inhibitors with notable efficacy in recurrent/metastatic HNSCC patients. However, HNSCC remains poorly served by biomarkers that can direct treatment in a personalised fashion to target the tumour heterogeneity seen between patients. Detection and analysis of circulating tumour cells (CTCs) in HNSCC has provided a previously unseen view of the metastasis forming cells that are potentially contributing to poor clinical outcomes. In particular, identifying CTC expression of phenotypic and druggable protein markers has allowed CTC sub-populations to be defined that hold prognostic value or are potential therapeutic targets themselves. The aim of this systematic review was to examine the role of CTC immune-marker expression as prognostic/therapeutic biomarkers in HNSCC by evaluating progress to date and discussing areas for future research. Our results highlight how few studies have been able to demonstrate prognostic significance of immune-marker expression in CTCs. As expected, the immune checkpoint PD-L1 was the most widely investigated marker. However, no studies evaluated CTC target immune marker expression in immunotherapy cohorts. Despite these findings, the data presented demonstrate promise that CTCs may be a source of future biomarkers for immunotherapy and will provide valuable information regarding the potential immune evasion of these metastasis forming cells.

Keywords: HNSCC; circulating tumour cell; head and neck cancer; immune marker; immunotherapy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study selection flowchart. CTC: circulating tumour cell.
Figure 2
Figure 2
Forest plot and meta-analysis of pre-treatment CTC immune-marker expression as a biomarker of progression-free survival (PFS): Meta analysis performed on CTC PD-L1 expression (presented data may vary from Table 2 due to conversion formulae).
Figure 3
Figure 3
Forest plot of pre-treatment CTC immune-marker expression as a biomarker of overall survival (OS) (presented data may vary from Table 2 due to conversion formulae).
Figure 4
Figure 4
Forest plot of post-treatment CTC immune-marker expression as a biomarker of progression-free survival (PFS) (presented data may vary from Table 2 due to conversion formulae).
Figure 5
Figure 5
Forest plot of post-treatment CTC immune-marker expression as a biomarker of overall survival (OS) (presented data may vary from Table 2 due to conversion formulae).
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