Efficacy and safety of nivolumab in 100 patients with recurrent or metastatic head and neck cancer – a retrospective multicentre study

Abstract Background: No large-scale retrospective studies have examined the efficacy and safety of nivolumab. Objective: This retrospective study aimed to investigate the efficacy and safety of nivolumab administered to patients in multiple facilities. Material and methods: The primary endpoint was overall response rate (ORR) and secondary endpoints were progression-free survival (PFS) and overall survival (OS). For safety, adverse event occurrence rates by grade, deaths and severe adverse events were investigated. OS and PFS were also examined according to whether immune-related adverse events (irAEs) appeared. Statistical analysis was conducted using log-rank testing, with values of p < .05 considered significant. Results: Nivolumab was administered to 100 patients with a history of receiving platinum-based drugs. ORR was 13.5% and disease control rate was 49.0%. Median PFS was 3.7 months. Median OS was 9.6 months. For all grades, irAEs occurred in 30 patients. The 1-year survival rate in the subgroup without irAEs was 34.0%, compared to 52.6% with irAEs (p = .041). Conclusions and significance: The 1-year survival rate was better in patients who developed irAEs. This is a new finding for head and neck cancer. Appearance of irAEs could also be used as an indicator of expected therapeutic effect in head and neck cancer.

[1]  Xin Wang,et al.  Treatment-Related Adverse Events of PD-1 and PD-L1 Inhibitors in Clinical Trials: A Systematic Review and Meta-analysis. , 2019, JAMA oncology.

[2]  A. Alfranca,et al.  Immune-related adverse events predict the therapeutic efficacy of anti-PD-1 antibodies in cancer patients. , 2019, European journal of cancer.

[3]  N. Hanai,et al.  Prognostic Markers in Head and Neck Cancer Patients Treated with Nivolumab , 2018, Cancers.

[4]  B. Costello,et al.  Antitumor Activity of Nivolumab in Recurrent and Metastatic Nasopharyngeal Carcinoma: An International, Multicenter Study of the Mayo Clinic Phase 2 Consortium (NCI-9742). , 2018, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[5]  Dong-Wan Kim,et al.  Post-treatment neutrophil-to-lymphocyte ratio at week 6 is prognostic in patients with advanced non-small cell lung cancers treated with anti-PD-1 antibody , 2018, Cancer Immunology, Immunotherapy.

[6]  T. Morimoto,et al.  Early Immune‐Related Adverse Events and Association with Outcome in Advanced Non‐Small Cell Lung Cancer Patients Treated with Nivolumab: A Prospective Cohort Study , 2017, Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer.

[7]  H. Taniguchi,et al.  Remarkable response of nivolumab‐refractory lung cancer to salvage chemotherapy , 2017, Thoracic cancer.

[8]  M. Monga,et al.  A randomized, open-label, Phase III clinical trial of nivolumab vs. therapy of investigator's choice in recurrent squamous cell carcinoma of the head and neck: A subanalysis of Asian patients versus the global population in checkmate 141. , 2017, Oral oncology.

[9]  Kaoru Tanaka,et al.  Association of Immune-Related Adverse Events With Nivolumab Efficacy in Non–Small-Cell Lung Cancer , 2017, JAMA oncology.

[10]  G. Burton,et al.  Excellent response to chemotherapy post immunotherapy , 2017, Oncotarget.

[11]  K. Harrington,et al.  Nivolumab for Recurrent Squamous-Cell Carcinoma of the Head and Neck. , 2016, The New England journal of medicine.

[12]  G. Gibney,et al.  Nivolumab in Resected and Unresectable Metastatic Melanoma: Characteristics of Immune-Related Adverse Events and Association with Outcomes , 2015, Clinical Cancer Research.

[13]  M. Burotto,et al.  Pseudoprogression and Immune-Related Response in Solid Tumors. , 2015, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[14]  Zhao-yang Yang,et al.  Systemic Immune-inflammation Index, Based on Platelet Counts and Neutrophil-Lymphocyte Ratio, Is Useful for Predicting Prognosis in Small Cell Lung Cancer. , 2015, The Tohoku journal of experimental medicine.

[15]  Y. Kanda,et al.  Investigation of the freely available easy-to-use software ‘EZR' for medical statistics , 2012, Bone Marrow Transplantation.

[16]  J. Banchereau,et al.  Assessing oncologic benefit in clinical trials of immunotherapy agents. , 2010, Annals of oncology : official journal of the European Society for Medical Oncology.

[17]  Axel Hoos,et al.  Guidelines for the Evaluation of Immune Therapy Activity in Solid Tumors: Immune-Related Response Criteria , 2009, Clinical Cancer Research.

[18]  S. Steinberg,et al.  Prognostic Factors Related to Clinical Response in Patients with Metastatic Melanoma Treated by CTL-Associated Antigen-4 Blockade , 2007, Clinical Cancer Research.

[19]  K. Markou,et al.  National Comprehensive Cancer Network (NCCN) Head and Neck Cancers NCCN Clinical Practice Guidelines in Oncology . 2010. , 2011 .