Head and neck cancer is the sixth most prevalent cancer, with an annual incidence of more than 600,000 cases and a worldwide mortality rate of 350,000 deaths a year. Surgery, chemotherapy, and radiotherapy are the treatment modalities of choice. Induction chemotherapy (IC) is sometimes advised in select patients based on organ preservation considerations due to the critical significance of the head and neck anatomical structures.
This study, published in BMC Cancer, examines the safety and efficacy of sintilimab paired with induction chemotherapy (IC) in treating patients with locally progressed head and neck squamous cell carcinoma (HNSCC).
A total of 163 patients participated in the study, with 98 receiving only IC and 65 receiving both IC and sintilimab. The IC regimen included docetaxel (75 mg/m2), platinum (75 mg/m2), and fluorouracil (750 mg/m2/day for 5 days) [TPF]. Sintilimab was given intravenously at a dose of 200 mg on the first day of each cycle, once every three weeks.
Participants in the IC-only group received two cycles of TPF, whereas those in the IC with immunotherapy group received two cycles of TPF and sintilimab simultaneously. Following neoadjuvant therapy, the patients either underwent chemoradiotherapy or surgery. The two groups were compared in terms of objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and toxicities.
Ultimately, it was found that in the IC-only group, complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) occurred in 10.2%, 58.2%, 25.5%, and 6.1% of patients, respectively, and the ORR was 68.4%. In the IC with sintilimab group, CR, PR, SD, and PD occurred in 23.1%, 61.5%, 10.8%, and 4.6% of patients, respectively. The ORR was 84.6%, which was significantly higher than that of the IC-only group.
Moreover, acute toxicity grade 3-4 was seen in 15.3% and 18.5% of individuals in the IC-only and IC with sintilimab groups, respectively. Lastly, the IC-only group had a two-year PFS rate of 27%, whereas the IC plus sintilimab group had a two-year PFS rate of 44%, which was a significant difference. The two-year OS rates in the IC-only and IC with sintilimab groups were 61% and 70%, respectively.
The researchers concluded that adding sintilimab to TPF in the treatment of patients with locally advanced HNSCC is safe and may result in a prolonged PFS time. This combined regimen could be a new treatment option for this population [1].
Source:
[1] Li, X., Fang, Q., Du, W., Zhang, X., Dai, L., & Qiao, Y. (2021). Induction chemotherapy combined with immunotherapy in locally advanced head and neck squamous cell carcinoma. BMC Cancer, 21(1). https://doi.org/10.1186/s12885-021-08373-8
