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. 2023 Dec;72(12):4161-4168.
doi: 10.1007/s00262-023-03550-z. Epub 2023 Oct 7.

PD-1 Inhibitors combined with paclitaxel (Albumin-bound) and cisplatin for larynx preservation in locally advanced laryngeal and hypopharyngeal squamous cell carcinoma: a retrospective study

Qi Fang #  1 , Pengfei Xu #  1 , Fei Cao #  1 , Di Wu  2 , Xuekui Liu  3
Affiliations

PD-1 Inhibitors combined with paclitaxel (Albumin-bound) and cisplatin for larynx preservation in locally advanced laryngeal and hypopharyngeal squamous cell carcinoma: a retrospective study

Qi Fang et al. Cancer Immunol Immunother. 2023 Dec.

Abstract

Background: laryngeal and hypopharyngeal squamous cell carcinoma (SCC) is a common head and neck cancer with significant impact on quality of life due to its crucial roles in vocalization, airway protection, and swallowing. This retrospective study aims to evaluate the efficacy and larynx organ preservation of neoadjuvant treatment with PD-1 inhibitors in combination with paclitaxel (Albumin-bound) and cisplatin for locally advanced laryngeal and hypopharyngeal SCC.

Methods: Medical records of consecutive patients diagnosed with histologically or cytologically confirmed locally advanced SCC of the larynx and hypopharynx, who received PD-1 inhibitor therapy at a single tertiary care center, were reviewed from January 1, 2019, to December 15, 2022. The patients were treated with a combination of PD-1 inhibitors, paclitaxel (Albumin-bound) 260mg/m2, and cisplatin 60mg/m2 (TP) as their first-line therapy. Survival outcomes, laryngectomy-free survival (LFS) rates and response rates were assessed.

Results: The study cohort comprised 156 patients, predominantly male, with a median age of 60.4 years. The estimated one-year overall survival (OS) rate was 94.1%, two-year OS rate was 82.5%, one-year progression-free survival (PFS) rate was 80.4%, and two-year PFS rate was 66.3%. The one-year LFS was 86.4%, and the two-year LFS rate was 73.0%. The overall response rate after TP + PD-1 inhibitors therapy was 88.5%. Common treatment-associated adverse events included rash, thyroid function abnormalities, myelosuppression, and colitis.

Conclusion: Neoadjuvant therapy with PD-1 inhibitors in combination with paclitaxel (Albumin-bound) and cisplatin showed promising efficacy and tolerability for larynx preservation in locally advanced laryngeal and hypopharyngeal SCC. The high response rates and favorable survival outcomes suggest this approach as a potential treatment option. Prospective randomized controlled trials are needed to further validate these findings and establish the role of immunotherapy in larynx preservation.

Keywords: Hypopharyngeal cancer; Laryngeal cancer; Larynx preservation; Neoadjuvant therapy; PD-1 inhibitors.

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Conflict of interest statement

All authors have read and approved the submission of the manuscript, which has not been published and is not considered for publication elsewhere in whole or part in any language. The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Treatment process of 156 patients with laryngeal or hypopharyngeal SCC. CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease; SCC, squamous cell carcinoma; CCR, concurrent chemoradiotherapy
Fig. 2
Fig. 2
Overall Survival, Progression-Free Survival, and Laryngectomy-Free Survival in the Entire Cohort
Fig. 3
Fig. 3
Radiographic response after TP + PD-1 inhibitors. CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease; TP, paclitaxel (Albumin-bound) + cisplatin
See this image and copyright information in PMC

References

    1. Forastiere AA, Ismaila N, Lewin JS, et al. Use of larynx-preservation strategies in the treatment of laryngeal cancer: american society of clinical oncology clinical practice guideline update. J Clin Oncol. 2018;36(11):1143–1169. doi: 10.1200/JCO.2017.75.7385. - DOI - PubMed
    1. Grover S, Swisher-McClure S, Mitra N, et al. Total laryngectomy versus larynx preservation for T4a larynx cancer: patterns of care and survival outcomes. Int J Radiat Oncol Biol Phys. 2015;92(3):594–601. doi: 10.1016/j.ijrobp.2015.03.004. - DOI - PubMed
    1. Rosenthal DI, Mohamed AS, Weber RS, et al. Long-term outcomes after surgical or nonsurgical initial therapy for patients with T4 squamous cell carcinoma of the larynx: A 3-decade survey. Cancer. 2015;121(10):1608–1619. doi: 10.1002/cncr.29241. - DOI - PMC - PubMed
    1. Silverman DA, Puram SV, Rocco JW, Old MO, Kang SY. Salvage laryngectomy following organ-preservation therapy-an evidence-based review. Oral Oncol. 2019;88:137–144. doi: 10.1016/j.oraloncology.2018.11.022. - DOI - PubMed
    1. Spaulding MB, Fischer SG, Wolf GT. Tumor response, toxicity, and survival after neoadjuvant organ-preserving chemotherapy for advanced laryngeal carcinoma. the department of veterans affairs cooperative laryngeal cancer study group. J Clin Oncol. 1994;12(8):1592–1599. doi: 10.1200/JCO.1994.12.8.1592. - DOI - PubMed