Efficacy of PD-1 inhibitors combined with nab-paclitaxel and cisplatin in the neoadjuvant treatment of locally advanced hypopharyngeal squamous cell carcinoma
10.3760/cma.j.cn115330-20231016-00152
- VernacularTitle:PD-1抑制剂联合紫杉醇和顺铂新辅助治疗局部晚期下咽鳞癌的疗效分析
- Author:
Qi FANG
1
;
Pengfei XU
;
Fei CAO
;
Zheng ZHAO
;
Xinrui ZHANG
;
Di WU
;
Chunyan CHEN
;
Zhiming LI
;
Fei HAN
;
Xuekui LIU
Author Information
1. 中山大学肿瘤防治中心头颈外科 华南肿瘤学国家重点实验室 肿瘤学协同创新中心 广东省恶性肿瘤临床医学研究中心，广州 510060
- Keywords:
Hypopharyngeal neoplasms;
Carcinoma, squamous cell;
Neoadjuvant therapy;
Immunotherapy;
PD-1 inhibitor
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2024;59(7):750-757
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the efficacy of neoadjuvant treatment with PD-1 (programmed cell death protein 1) inhibitors combined with paclitaxel (albumin-conjugated) and cisplatin (TP regimen) for locally advanced hypopharyngeal squamous cell carcinoma and laryngeal organ function preservation.Methods:Data of 53 patients, including 51 males and 2 females, aged 38-70 years old, who were diagnosed with locally advanced hypopharyngeal squamous carcinoma confirmed by histology and enhanced CT at the Cancer Prevention and Control Center of Sun Yat-sen University during the initial treatment from January 1, 2019 to January 15, 2023, were retrospectively analyzed. All patients received neoadjuvant therapy with PD-1 inhibitors combined with albumin-bound paclitaxel (260 mg/m 2) and cisplatin (60 mg/m 2) for 3 to 4 cycles. The main outcome measures were larynx dysfunction-free survival (LDFS), overall survival (OS), and progression-free survival (PFS). Survival curves were plotted using the Kaplan-Meier method, and Cox multifactorial analysis was further performed if Cox univariate analysis was statistically significant. Results:The overall efficiency was 90.6% (48/53). The 1-year and 2-year LDFS rates were 83.8% (95% CI: 74.0% to 94.8%) and 50.3% (95% CI: 22.1% to 91.6%), the 1-year and 2-year OS rates were 95.2% (95% CI: 88.9% to 100.0%) and 58.2% (95% CI: 25.6% to 81.8%), and the 1-year and 2-year PFS rates were 83.9% (95% CI: 74.2% to 94.9%) and 53.5% (95% CI: 32.1% to 89.1%). Adverse events associated with the neoadjuvant therapy were mainly myelosuppression (45.3%), gastrointestinal reactions (37.7%) and hypothyroidism (20.8%). Conclusion:The neoadjuvant treatment of locally advanced hypopharyngeal squamous cell carcinoma using PD-1 inhibitors combined with paclitaxel and cisplatin can provide with a higher survival rate with a improved laryngeal organ function preservation rate.
