PMID- 37311638
OWN - NLM
STAT- MEDLINE
DCOM- 20230615
LR  - 20230622
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 13
IP  - 6
DP  - 2023 Jun 13
TI  - Combination immunochemotherapy for recurrent or metastatic head and neck squamous 
      cell carcinoma: a systematic review and meta-analysis.
PG  - e069047
LID - 10.1136/bmjopen-2022-069047 [doi]
LID - e069047
AB  - OBJECTIVE: To evaluate the efficacy and safety of combination immunochemotherapy 
      regimens for the treatment of recurrent or metastatic head and neck squamous cell 
      carcinoma (R/M HNSCC). DESIGN: Meta-analysis and systematic review. DATA SOURCES: 
      PubMed, Embase, Web of Science and Cochrane library and the Clinicaltrials.gov 
      clinical trials registry were searched up to 14 March 2022. ELIGIBILITY CRITERIA 
      FOR SELECTING STUDIES: We included randomised controlled trials that compared 
      combination immunochemotherapy with conventional chemotherapy for R/M HNSCC. 
      Primary outcomes of interest were overall survival (OS), progression-free 
      survival (PFS), objective response rate (ORR) and adverse effects (AEs). DATA 
      EXTRACTION AND SYNTHESIS: Two reviewers independently extracted data and assessed 
      the risk of bias of the included studies. The HR and its 95% CI were used as the 
      effect analysis statistic for survival analysis, while the OR and its 95% CI were 
      used as the effect analysis statistic for dichotomous variables. These statistics 
      were extracted by the reviewers and aggregated using a fixed-effects model to 
      synthesise the data. RESULTS: A total of 1214 relevant papers were obtained after 
      the initial search, and five papers that met the inclusion criteria were 
      included; these studies included a total of 1856 patients with R/M HNSCC. 
      Meta-analysis showed that the OS and PFS of patients with R/M HNSCC in the 
      combination immunochemotherapy group were significantly longer than those in the 
      conventional chemotherapy group (HR=0.84; 95% CI 0.76, 0.94; p=0.002; HR=0.67; 
      95% CI 0.61, 0.75; p<0.0001), and the ORR was significantly higher (OR=1.90; 
      95% CI 1.54, 2.34; p<0.00001). The analysis of AEs showed that there was no 
      significant difference in the overall incidence rate of AEs between two groups 
      (OR=0.80; 95% CI 0.18, 3.58; p=0.77), but the rate of grade III and IV AEs was 
      significantly higher in patients in the combination immunochemotherapy group 
      (OR=1.39; 95% CI 1.12, 1.73; p=0.003). CONCLUSIONS: Combination 
      immunochemotherapy prolonged OS and PFS in patients with R/M HNSCC and improved 
      the ORR; while this approach did not increase the overall incidence of AEs in 
      patients, it increased the rate of grade III and IV AEs. PROSPERO REGISTRATION 
      NUMBER: CRD42022344166.
CI  - (c) Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Xu, Qiudong
AU  - Xu Q
AD  - Department of Oral and Maxillofacial Surgery, Wuxi Stomatology Hospital, Wuxi, 
      China.
AD  - Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of 
      Chongqing Medical University, Chongqing, China.
FAU - Huang, Shuang
AU  - Huang S
AD  - Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of 
      Chongqing Medical University, Chongqing, China.
FAU - Yang, Kai
AU  - Yang K
AUID- ORCID: 0000-0002-0884-3534
AD  - Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of 
      Chongqing Medical University, Chongqing, China cqfyyk@hotmail.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20230613
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Humans
MH  - Squamous Cell Carcinoma of Head and Neck/drug therapy
MH  - *Carcinoma
MH  - *Head and Neck Neoplasms/drug therapy
MH  - Immunotherapy
MH  - *Drug-Related Side Effects and Adverse Reactions
PMC - PMC10277053
OTO - NOTNLM
OT  - CHEMOTHERAPY
OT  - Head & neck tumours
OT  - Immunology
COIS- Competing interests: None declared.
EDAT- 2023/06/14 01:10
MHDA- 2023/06/15 06:42
PMCR- 2023/06/13
CRDT- 2023/06/13 21:13
PHST- 2023/06/15 06:42 [medline]
PHST- 2023/06/14 01:10 [pubmed]
PHST- 2023/06/13 21:13 [entrez]
PHST- 2023/06/13 00:00 [pmc-release]
AID - bmjopen-2022-069047 [pii]
AID - 10.1136/bmjopen-2022-069047 [doi]
PST - epublish
SO  - BMJ Open. 2023 Jun 13;13(6):e069047. doi: 10.1136/bmjopen-2022-069047.