Combination immunochemotherapy for recurrent or metastatic head and neck squamous cell carcinoma: a systematic review and meta-analysis

作者全名："Xu, Qiudong; Huang, Shuang; Yang, Kai"

作者地址："[Xu, Qiudong] Wuxi Stomatol Hosp, Dept Oral & Maxillofacial Surg, Wuxi, Peoples R China; [Xu, Qiudong; Huang, Shuang; Yang, Kai] Chongqing Med Univ, Affiliated Hosp 1, Dept Oral & Maxillofacial Surg, Chongqing, Peoples R China"

通信作者："Yang, K (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Oral & Maxillofacial Surg, Chongqing, Peoples R China."

来源：BMJ OPEN

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001014750700011

JCR分区：Q1

影响因子：2.4

年份：2023

卷号：13

期号：6

开始页：　

结束页：　

文献类型：Review

关键词：CHEMOTHERAPY; Head & neck tumours; Immunology

摘要："ObjectiveTo evaluate the efficacy and safety of combination immunochemotherapy regimens for the treatment of recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC).DesignMeta-analysis and systematic review.Data sourcesPubMed, Embase, Web of Science and Cochrane library and the Clinicaltrials.gov clinical trials registry were searched up to 14 March 2022.Eligibility criteria for selecting studiesWe included randomised controlled trials that compared combination immunochemotherapy with conventional chemotherapy for R/M HNSCC. Primary outcomes of interest were overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and adverse effects (AEs).Data extraction and synthesisTwo reviewers independently extracted data and assessed the risk of bias of the included studies. The HR and its 95% CI were used as the effect analysis statistic for survival analysis, while the OR and its 95% CI were used as the effect analysis statistic for dichotomous variables. These statistics were extracted by the reviewers and aggregated using a fixed-effects model to synthesise the data.ResultsA total of 1214 relevant papers were obtained after the initial search, and five papers that met the inclusion criteria were included; these studies included a total of 1856 patients with R/M HNSCC. Meta-analysis showed that the OS and PFS of patients with R/M HNSCC in the combination immunochemotherapy group were significantly longer than those in the conventional chemotherapy group (HR=0.84; 95% CI 0.76, 0.94; p=0.002; HR=0.67; 95% CI 0.61, 0.75; p<0.0001), and the ORR was significantly higher (OR=1.90; 95% CI 1.54, 2.34; p<0.00001). The analysis of AEs showed that there was no significant difference in the overall incidence rate of AEs between two groups (OR=0.80; 95% CI 0.18, 3.58; p=0.77), but the rate of grade III and IV AEs was significantly higher in patients in the combination immunochemotherapy group (OR=1.39; 95% CI 1.12, 1.73; p=0.003).ConclusionsCombination immunochemotherapy prolonged OS and PFS in patients with R/M HNSCC and improved the ORR; while this approach did not increase the overall incidence of AEs in patients, it increased the rate of grade III and IV AEs.PROSPERO registration numberCRD42022344166."

基金机构："Natural Science Foundation of Chongqing, China [cstc2018jcyjAX0208]; Chongqing Talents Innovation Leading Talents Project [CQYC20200303128]"

基金资助正文："This work was supported by Natural Science Foundation of Chongqing, China (cstc2018jcyjAX0208) and Chongqing Talents Innovation Leading Talents Project (CQYC20200303128)."