Clinical study on the effect of nivolumab on prolongation of the prognosis for recurrent and metastatic head-and-neck squamous cell carcinoma at our hospital

Abstract

In response to the results of the CheckMate 141 study, we started treatment with nivolumab for recurrent and metastatic head-and-neck squamous cell carcinoma (HNSCC) in October 2017. In this study, we examined whether nivolumab could prolong the prognosis in clinical practice. The subjects were patients who underwent palliative treatment for recurrent and metastatic HNSCC at our hospital from January 2010 to October 2019. We then extracted the nivolumab administration group and the pre and post nivolumab insurance listing groups, and divided them according to the availability of nivolumab administration after October 2017. The 1- and 2-year survival rates of the nivolumab administration group were 58.9% and 46.6%, respectively, which were higher than the CheckMate 141 study. In the pre and post nivolumab insurance listing groups, the overall survival rate was higher in the post group (the 1-year survival rates were 43.9% in the pre group vs. 70.5% in the post group, and the 2-year survival rates were 21.7% and 57.2%, respectively) (p < 0.001). The early Best Supportive Care (BSC) transition rate was lower in the post group (the BSC transition rates within 1 year after the start of palliative treatment were 52.3% in the pre group and 9.3% in the post group). In conclusion, the effect of nivolumab to prolong prognosis can be confirmed at our hospital, and the patients who receive BSC at an early stage have decreased because of the increase in treatment options for palliative drug therapy due to the development of nivolumab.