Systematic review and meta-analysis of pathologic response and survival after neoadjuvant immunotherapy for resectable mucosal HNSCC

Neoadjuvant immune checkpoint inhibitor (ICI) therapy for mucosal head and neck squamous cell carcinoma (HNSCC) can result in pathologic treatment response. However, whether this response is a meaningful surrogate endpoint for survival has yet to be determined. Systematic review and meta and meta-analysis of 11 trial involving 451 patients investigated the association of pathologic treatment response of mucosal NHSCC after neoadjuvant ICI with disease-free survival and overall survival. The analysis found that both partial pathologic response (≤ 50% residual viable tumor; HR 0.53; 95% CI 0.28-0.97) and major pathologic response (≤ 10% residual viable tumor; 0.34; 0.12-0.93) were associated with improved DFS up to 2 years. Pathologic response was not associated with improved OS. Nine of 11 studies were at low risk of bias. The authors conclude that pathologic response can be used as a surrogate for DFS after neoadjuvant ICI in resectable mucosal HNSCC.