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Comparative Study
. 2024 Oct 31:15:1466310.
doi: 10.3389/fimmu.2024.1466310. eCollection 2024.

Comparison of the efficacy and safety of neoadjuvant PD-1 inhibitors plus chemotherapy vs targeted therapy plus chemotherapy in locally advanced hypopharyngeal squamous cell carcinoma

Wen Gao #  1 , Lifei Feng #  1 , Xinming Zhao  1 , Zishi Huang  1 , Duoxuan Chen  1 , Gaofei Yin  1 , Wei Guo  1 , Qi Zhong  1 , Xiaohong Chen  1 , Jugao Fang  1 , Yang Zhang  1 , Zhigang Huang  1
Affiliations
Comparative Study

Comparison of the efficacy and safety of neoadjuvant PD-1 inhibitors plus chemotherapy vs targeted therapy plus chemotherapy in locally advanced hypopharyngeal squamous cell carcinoma

Wen Gao et al. Front Immunol. .

Abstract

Objective: To investigate the clinical efficacy, preservation of laryngeal function, and safety differences between PD-1 inhibitors combined with chemotherapy, and targeted therapy combined with chemotherapy in LA HPSCC patients.

Methods: This was a retrospective analysis of patients with LA HPSCC treated at Beijing Tongren Hospital, Capital Medical University from October, 2020 to March, 2024. A total of 110 eligible patients were included, 56 in the PD-1 inhibitors combined with chemotherapy group (Group A), and 54 in the targeted therapy combined with chemotherapy group (Group B). Relevant clinical data were collected, and the clinical efficacy, preservation of laryngeal function, complete response (CR) rate, pathological complete response (pCR) rate, major pathological response (MPR), and treatment-related adverse events (TRAEs) of the two groups were analyzed and compared.

Results: In both groups A and B, the objective response rate (ORR) and disease control rate (DCR) were similar with no significant differences, but the pCR rate in Group A was much higher than that in Group B, at 37.5% and 7.4%, respectively (p<0.001). The rate of primary tumor downstaging in group A was much higher than that in group B (76.8% vs. 38.9%) as well (p<0.0001). In addition, the 1y-OS rate in group A was 95.7%, compared to 87.0% in group B (p=0.106, HR=0.34; 95% CI: 0.114-1.013), and the 1y-PFS rate was 89.4% in group A compared to 85.2% in group B (p=0.399, HR=0.675; 95% CI: 0.275-1.659). Furthermore, the larynx function preservation rate was significantly higher in group A at 85.7%, compared to that of group B at only 66.7% (p=0.019). There were no deaths due to TRAEs in either group, and there was no significant difference in the incidence of grade 3-4 TRAEs between the two groups either (p=0.77). The main TRAEs in Group A were metabolism and nutrition disorders (52/56, 92.9%) and, in Group B were blood and lymphatic system disorders (40/54, 74.1%).

Conclusions: PD-1 inhibitors combined with chemotherapy showed better short-term efficacy compared to targeted therapy. Additionally, a trend toward improved long-term survival was observed with PD-1 inhibitors but not with targeted therapy. Results for both groups indicate that neoadjuvant therapy is both safe and manageable.

Keywords: PD-1 inhibitors; comparison of efficacy; drug response; hypopharyngeal squamous cell carcinoma; immunotherapy.

PubMed Disclaimer

Conflict of interest statement

The authors declare that this research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
A typical case of immunotherapy combined with chemotherapy as neoadjuvant treatment [Group (A) and Group (B)], with CT, MRI, and laryngoscope images of the primary tumor before and after two cycles of treatment.
Figure 2
Figure 2
Comparison of overall survival (OS) between the two groups.
Figure 3
Figure 3
Comparison of progression-free survival (PFS) between the two groups.
Figure 4
Figure 4
OS rate and PFS rate of patients with different CPS scores in Group A.
Figure 5
Figure 5
Patients who experienced severe adverse events during immunotherapy combined with chemotherapy. (A) Systemic rash; (B) immune-mediated pneumonitis.
See this image and copyright information in PMC

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