Neoadjuvant chemoimmunotherapy for locally advanced squamous cell carcinoma of the head and neck: Systematic review and meta-analysis
Background: Neoadjuvant chemoimmunotherapy emerged as a promising treatment for locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). However, a comparison of clinical outcomes with neoadjuvant chemotherapy was lacking. Objective: To provide evidence supporting clinical decision-...
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Elsevier
2025-02-01
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| Series: | Pharmacological Research |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1043661825000234 |
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| author | Xiayi Zhu Jie Qiu Ya Zhang Chunni Lin Xiaohui Wang Xiwei Shi Siya Yang Qiaoyan Wu Li Cong |
| author_facet | Xiayi Zhu Jie Qiu Ya Zhang Chunni Lin Xiaohui Wang Xiwei Shi Siya Yang Qiaoyan Wu Li Cong |
| author_sort | Xiayi Zhu |
| collection | DOAJ |
| description | Background: Neoadjuvant chemoimmunotherapy emerged as a promising treatment for locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). However, a comparison of clinical outcomes with neoadjuvant chemotherapy was lacking. Objective: To provide evidence supporting clinical decision-making for neoadjuvant chemoimmunotherapy in LA-SCCHN treatment. Methods: Literature was retrieved from PubMed, Web of Science, Embase, and the Cochrane Library for studies on the efficacy and safety of neoadjuvant chemoimmunotherapy and chemotherapy in LA-SCCHN published before August 10, 2024. The study was registered in the PROSPERO (CRD42024573816). Results: A total of 28 clinical trials with 2021 patients were included. The neoadjuvant chemoimmunotherapy group had significantly higher pathologic complete response (pCR) (33 % vs. 18 %, P = 0.04) and partial response (PR) (65 % vs. 38 %, P < 0.01). No significant differences were found in overall survival (OS) (hazard ratio: 0.85, 95 % CI: 0.77–0.93) and progression-free survival (PFS) (hazard ratio: 0.72, 95 % CI: 0.61–0.86). Regarding safety outcomes, in the single-arm trials, grade 3–4 treatment-related adverse events (TRAEs) occurred in 14 % of the chemoimmunotherapy group and 13 % of the chemotherapy group, with grade 5 TRAEs at 0 % and 4 %, respectively, showing no significant difference (P = 0.80; P = 0.08). In both RCTs and non-RCT, chemoimmunotherapy had a higher Risk Ratio (RR) for grade 3–4 TRAEs (RR: 1.42, 95 % CI: 0.87–2.31). Conclusion: Neoadjuvant chemoimmunotherapy has shown promising efficacy and safety for LA-SCCHN, but further randomized trials are needed to confirm long-term survival benefits. |
| format | Article |
| id | doaj-art-bae7185d979e4bf697747563a61d3f50 |
| institution | Kabale University |
| issn | 1096-1186 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pharmacological Research |
| spelling | doaj-art-bae7185d979e4bf697747563a61d3f502025-02-08T04:59:47ZengElsevierPharmacological Research1096-11862025-02-01212107598Neoadjuvant chemoimmunotherapy for locally advanced squamous cell carcinoma of the head and neck: Systematic review and meta-analysisXiayi Zhu0Jie Qiu1Ya Zhang2Chunni Lin3Xiaohui Wang4Xiwei Shi5Siya Yang6Qiaoyan Wu7Li Cong8School of Nursing, Hunan Normal University, Changsha, Hunan 410013, ChinaSchool of Nursing, Hunan Normal University, Changsha, Hunan 410013, ChinaSchool of Nursing, Hunan Normal University, Changsha, Hunan 410013, ChinaSchool of Nursing, Hunan Normal University, Changsha, Hunan 410013, ChinaSchool of Nursing, Hunan Normal University, Changsha, Hunan 410013, ChinaSchool of Nursing, Hunan Normal University, Changsha, Hunan 410013, ChinaSchool of Nursing, Hunan Normal University, Changsha, Hunan 410013, ChinaSchool of Nursing, Hunan Normal University, Changsha, Hunan 410013, ChinaCorresponding author.; School of Nursing, Hunan Normal University, Changsha, Hunan 410013, ChinaBackground: Neoadjuvant chemoimmunotherapy emerged as a promising treatment for locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). However, a comparison of clinical outcomes with neoadjuvant chemotherapy was lacking. Objective: To provide evidence supporting clinical decision-making for neoadjuvant chemoimmunotherapy in LA-SCCHN treatment. Methods: Literature was retrieved from PubMed, Web of Science, Embase, and the Cochrane Library for studies on the efficacy and safety of neoadjuvant chemoimmunotherapy and chemotherapy in LA-SCCHN published before August 10, 2024. The study was registered in the PROSPERO (CRD42024573816). Results: A total of 28 clinical trials with 2021 patients were included. The neoadjuvant chemoimmunotherapy group had significantly higher pathologic complete response (pCR) (33 % vs. 18 %, P = 0.04) and partial response (PR) (65 % vs. 38 %, P < 0.01). No significant differences were found in overall survival (OS) (hazard ratio: 0.85, 95 % CI: 0.77–0.93) and progression-free survival (PFS) (hazard ratio: 0.72, 95 % CI: 0.61–0.86). Regarding safety outcomes, in the single-arm trials, grade 3–4 treatment-related adverse events (TRAEs) occurred in 14 % of the chemoimmunotherapy group and 13 % of the chemotherapy group, with grade 5 TRAEs at 0 % and 4 %, respectively, showing no significant difference (P = 0.80; P = 0.08). In both RCTs and non-RCT, chemoimmunotherapy had a higher Risk Ratio (RR) for grade 3–4 TRAEs (RR: 1.42, 95 % CI: 0.87–2.31). Conclusion: Neoadjuvant chemoimmunotherapy has shown promising efficacy and safety for LA-SCCHN, but further randomized trials are needed to confirm long-term survival benefits.http://www.sciencedirect.com/science/article/pii/S1043661825000234Squamous cell carcinoma of head and neckChemoimmunotherapyChemotherapyNeoadjuvant therapyEfficacySafety |
| spellingShingle | Xiayi Zhu Jie Qiu Ya Zhang Chunni Lin Xiaohui Wang Xiwei Shi Siya Yang Qiaoyan Wu Li Cong Neoadjuvant chemoimmunotherapy for locally advanced squamous cell carcinoma of the head and neck: Systematic review and meta-analysis Pharmacological Research Squamous cell carcinoma of head and neck Chemoimmunotherapy Chemotherapy Neoadjuvant therapy Efficacy Safety |
| title | Neoadjuvant chemoimmunotherapy for locally advanced squamous cell carcinoma of the head and neck: Systematic review and meta-analysis |
| title_full | Neoadjuvant chemoimmunotherapy for locally advanced squamous cell carcinoma of the head and neck: Systematic review and meta-analysis |
| title_fullStr | Neoadjuvant chemoimmunotherapy for locally advanced squamous cell carcinoma of the head and neck: Systematic review and meta-analysis |
| title_full_unstemmed | Neoadjuvant chemoimmunotherapy for locally advanced squamous cell carcinoma of the head and neck: Systematic review and meta-analysis |
| title_short | Neoadjuvant chemoimmunotherapy for locally advanced squamous cell carcinoma of the head and neck: Systematic review and meta-analysis |
| title_sort | neoadjuvant chemoimmunotherapy for locally advanced squamous cell carcinoma of the head and neck systematic review and meta analysis |
| topic | Squamous cell carcinoma of head and neck Chemoimmunotherapy Chemotherapy Neoadjuvant therapy Efficacy Safety |
| url | http://www.sciencedirect.com/science/article/pii/S1043661825000234 |
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