Risk Factors for Progressive Disease After Immune Checkpoint Inhibitor Therapy in Head and Neck Squamous Cell Carcinoma.

Abstract

This study analyzed the clinical features of patients with recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC), who developed progressive disease (PD) after immune checkpoint inhibitor (ICI) therapy. We retrospectively analyzed 256 patients with R/M HNSCC treated with ICIs at 11 medical centers. Associations between the treatment outcomes-best response, overall survival, and progression-free survival-and various clinical factors were analyzed. The objective response rate was 19.5% and PD was observed in 50.4% of the patients. A high neutrophil-to-lymphocyte ratio (NLR > 4; HR, 2.20 [1.28-3.78]) and large tumor size (sum of the target lesions > 40 mm; HR, 1.74 [1.03-2.94]) were significant risk factors for PD. High NLR (HR, 2.00 [1.42-2.82]), poor performance status (ECOG PS 2-3; HR, 3.51 [2.04-6.05]), and large tumor size (HR. 1.63 [1.19-2.24]) were independently associated with poor overall survival. Patients with high NLR and large tumor size are at higher risk of PD during ICI therapy.