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SYSTEMATIC REVIEW article

Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1467306
This article is part of the Research Topic The Role of the Microbiome in Modulating Response and Adverse Events in Solid Tumor Immunotherapy Treated Patients View all articles

Evaluating the efficacy and safety of different neoadjuvant immunotherapy combinations in locally advanced HNSCC: a systematic review and meta-analysis

Provisionally accepted
Chang Liu Chang Liu 1Mingzhu Li Mingzhu Li 2*Xiaojie Liu Xiaojie Liu 1*Ting Shi Ting Shi 1*Yun Wang Yun Wang 1*Chaoyang Sui Chaoyang Sui 1*Wenan Zhang Wenan Zhang 1*Bowen Wang Bowen Wang 1*
  • 1 Department of Burns and Plastic Surgery, Yantaishan Hospital, Yantai, China
  • 2 Department of implantology, Affiliated Hospital of Binzhou Medical College, Yantai Stomatology Hospital, Yantai, China

The final, formatted version of the article will be published soon.

    Background: Immune checkpoint inhibitors have demonstrated promising therapeutic outcomes in recurrent/metastatic (R/M) Head and Neck Squamous Cell Carcinoma (HNSCC), prompting numerous clinical trials to investigate the safety and efficacy of this approach in neoadjuvant therapy. This systematic review aims to consolidate and analyze the findings from various clinical trials combining neoadjuvant immunotherapy for HNSCC, with the goal of identifying the most effective neoadjuvant immunotherapy regimen. Methods: The system conducted searches across electronic databases including PubMed, Embase, the Cochrane Library and Web of science from their inception to July 1, 2024. The primary focus was on evaluating efficacy (particularly pathological complete response (pCR), major pathological response (MPR), and overall response rate (ORR)) and safety (primarily assessed by grade 3-4 treatment-related adverse reactions). Results: A total of 1943 patients from 32 studies were analyzed. Combining neoadjuvant immunotherapy with chemotherapy or radiotherapy demonstrated superiority over neoadjuvant immunotherapy alone in terms of the MPR rate, while showing no statistically significant difference in the pCR rate. Furthermore, the combination of neoadjuvant immunotherapy with chemotherapy or radiotherapy exhibited a lower CR rate compared to neoadjuvant immunotherapy with radiotherapy alone, but a higher PR rate and SD rate. Apart from the neoadjuvant immunotherapy group in isolation, there were no statistically significant differences in grade ≥3 treatment-related adverse events (TRAEs) and immune-related adverse events (irAEs) among the other three combination therapy groups. Conclusion: This systematic review and meta-analysis indicate that patients with locally advanced HNSCC might benefit from neoadjuvant immunotherapy, particularly when used in conjunction with chemotherapy or radiotherapy. Nonetheless, additional data is required to definitively confirm its efficacy.

    Keywords: HNSCC, neoadjuvant immunotherapy, efficacy, Safety, Meta-analysis

    Received: 19 Jul 2024; Accepted: 12 Aug 2024.

    Copyright: © 2024 Liu, Li, Liu, Shi, Wang, Sui, Zhang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Mingzhu Li, Department of implantology, Affiliated Hospital of Binzhou Medical College, Yantai Stomatology Hospital, Yantai, China
    Xiaojie Liu, Department of Burns and Plastic Surgery, Yantaishan Hospital, Yantai, China
    Ting Shi, Department of Burns and Plastic Surgery, Yantaishan Hospital, Yantai, China
    Yun Wang, Department of Burns and Plastic Surgery, Yantaishan Hospital, Yantai, China
    Chaoyang Sui, Department of Burns and Plastic Surgery, Yantaishan Hospital, Yantai, China
    Wenan Zhang, Department of Burns and Plastic Surgery, Yantaishan Hospital, Yantai, China
    Bowen Wang, Department of Burns and Plastic Surgery, Yantaishan Hospital, Yantai, China

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