Abstract 948P
Background
Immune checkpoint inhibitors (ICI) improve survival in patients (pts) with recurrent-metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN). Little is known about the characteristics of pts who are more likely to experience a long term benefit from ICI therapy. We report a retrospective analysis of the pre-treatment characteristics and long term outcomes of R/M SCCHN pts that received ICI for at least 12 months and/or discontinued therapy due to grade 3-4 ICI related toxicity.
Methods
Between January 2016 and December 2019, 181 R/M SCCHN pts were treated with ICI as second+ line therapy with 26 pts meeting inclusion criteria for this analysis. Descriptive statistics were used to explore study variables.
Results
21 pts (85%) received ICI for at least 12 months and 4 pts (15%) stopped due to toxicity. Sex (M/F) 22/4. Age (mean) 62.2 years. 13 pts received pembrolizumab (50%), 10 pts nivolumab (38%), 3 pts ipilimumab+nivolumab (12%). Tumor sites: oropharynx 11 (42%), oral cavity 7 (27%), others 8 (31%). P16 status positive/negative: 10/16. Median follow-up: 21.5 months.1 year OS 100%. 21 pts (81%) achieved a complete response (CR) and 5 pts (19%) achieved less than a CR (SD: 4 and PR: 1). Pts that obtained a CR had lower pretreatment neutrophil counts (median: 4.07 vs 4.58), neutrophil to lymphocyte ratio (NLR) (median 4.03 vs 6.54), platelet to lymphocyte ratio (PLR) (median 243 vs 427) and higher pretreatment levels of lymphocytes (median 0.87 vs 0.60).
Conclusions
A small percentage of R/M SCCHN pts will obtain a long term benefit from treatment with ICI. Pretreatment neutrophil and lymphocyte counts in combination with PLR and NLR should be studied as a potential marker for treatment response and a predictor for long term outcomes.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The Ohio State University Wexner Medical Center.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.