27 Evaluating the impact of age on biomarkers for and efficacy of neoadjuvant immune checkpoint inhibitor therapy for head and neck squamous cell carcinoma
Abstract
Background Several recent window-of-opportunity trials (WOT) have demonstrated the feasibility of immune checkpoint inhibitors (ICIs) in a neoadjuvant setting for early-stage resectable head and neck squamous cell carcinoma (HNSCC). Previous research suggests age may influence the efficacy of ICI, reporting comparable or improved responses to ICIs in older patients treated for recurrent/metastatic HNSCC.1 2 We investigate the age-related differences in response to neoadjuvant ICI therapy for HPV+ HNSCC patients. Methods The following single-center randomized clinical WOTs in operable HNSCC were conducted: 1) durvalumab (aPD-L1)±metformin (D/M), 2) nivolumab (aPD-1)±tadalafil, 3) nivolumab±indoleamine-2,3-dioxygenase. Older patients were defined as those ≥60 y/o, which is the median age of cohort. Chi-squared test and Kaplan-Meier analysis with log-rank test were performed to compare response (pathologic treatment effect [pTE]>20%) and overall survival (OS), respectively. Unbiased gene set enrichment analysis (GSEA) using the molecular signatures database (MSigD) Hallmark gene set was conducted to compare cross-sectional pre- and post-treatment patterns of gene expression between age cohorts.3 Spatial transcriptomics (Nanostring GeoMx) was performed across CD45+, CD163+, and panCK+ segments for patients who received D/M. Results Of 61 patients with HPV+ HNSCC, 29 (47.5%) were <60 y/o and 31 (52.5%) were ≥60 y/o. pTE was achieved in 16/29 (55.2%) patients <60 y/o and 11/32…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 61 participants or records.
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