Risk Factors for Progressive Disease After Immune Checkpoint Inhibitor Therapy in Head and Neck Squamous Cell Carcinoma

Seo Yoon Jang; Yun Gyoo Lee; Sang Hoon Chun; Ji Hyun Park; Keon Uk Park; Hyun Chang; Keun Wook Lee; Hye Ryun Kim; Seong Hoon Shin; Ho Jung An; Kyoung Eun Lee; In Gyu Hwang; Myung Ju Ahn; Sung Bae Kim; Bhumsuk Keam

doi:10.1002/hed.28071

Risk Factors for Progressive Disease After Immune Checkpoint Inhibitor Therapy in Head and Neck Squamous Cell Carcinoma

Seo Yoon Jang, Yun Gyoo Lee, Sang Hoon Chun, Ji Hyun Park, Keon Uk Park, Hyun Chang, Keun Wook Lee, Hye Ryun Kim, Seong Hoon Shin, Ho Jung An, Kyoung Eun Lee, In Gyu Hwang, Myung Ju Ahn, Sung Bae Kim, Bhumsuk Keam

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Background: This study analyzed the clinical features of patients with recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC), who developed progressive disease (PD) after immune checkpoint inhibitor (ICI) therapy. Methods: We retrospectively analyzed 256 patients with R/M HNSCC treated with ICIs at 11 medical centers. Associations between the treatment outcomes―best response, overall survival, and progression-free survival―and various clinical factors were analyzed. Results: The objective response rate was 19.5% and PD was observed in 50.4% of the patients. A high neutrophil-to-lymphocyte ratio (NLR > 4; HR, 2.20 [1.28–3.78]) and large tumor size (sum of the target lesions > 40 mm; HR, 1.74 [1.03–2.94]) were significant risk factors for PD. High NLR (HR, 2.00 [1.42–2.82]), poor performance status (ECOG PS 2–3; HR, 3.51 [2.04–6.05]), and large tumor size (HR. 1.63 [1.19–2.24]) were independently associated with poor overall survival. Conclusions: Patients with high NLR and large tumor size are at higher risk of PD during ICI therapy.

Original language	English
Pages (from-to)	1621-1630
Number of pages	10
Journal	Head and Neck
Volume	47
Issue number	6
DOIs	https://doi.org/10.1002/hed.28071
State	Published - Jun 2025

Bibliographical note

Publisher Copyright:
© 2025 Wiley Periodicals LLC.

Keywords

head and neck squamous cell carcinoma
immune checkpoint inhibitor
neutrophil-to-lymphocyte ratio
progressive disease
recurrent and/or metastatic

Access to Document

10.1002/hed.28071

Cite this

Jang, S. Y., Lee, Y. G., Chun, S. H., Park, J. H., Park, K. U., Chang, H., Lee, K. W., Kim, H. R., Shin, S. H., An, H. J., Lee, K. E., Hwang, I. G., Ahn, M. J., Kim, S. B., & Keam, B. (2025). Risk Factors for Progressive Disease After Immune Checkpoint Inhibitor Therapy in Head and Neck Squamous Cell Carcinoma. Head and Neck, 47(6), 1621-1630. https://doi.org/10.1002/hed.28071

@article{5598801f1cc544ef87948c089306f8ce,

title = "Risk Factors for Progressive Disease After Immune Checkpoint Inhibitor Therapy in Head and Neck Squamous Cell Carcinoma",

abstract = "Background: This study analyzed the clinical features of patients with recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC), who developed progressive disease (PD) after immune checkpoint inhibitor (ICI) therapy. Methods: We retrospectively analyzed 256 patients with R/M HNSCC treated with ICIs at 11 medical centers. Associations between the treatment outcomes―best response, overall survival, and progression-free survival―and various clinical factors were analyzed. Results: The objective response rate was 19.5\% and PD was observed in 50.4\% of the patients. A high neutrophil-to-lymphocyte ratio (NLR > 4; HR, 2.20 [1.28–3.78]) and large tumor size (sum of the target lesions > 40 mm; HR, 1.74 [1.03–2.94]) were significant risk factors for PD. High NLR (HR, 2.00 [1.42–2.82]), poor performance status (ECOG PS 2–3; HR, 3.51 [2.04–6.05]), and large tumor size (HR. 1.63 [1.19–2.24]) were independently associated with poor overall survival. Conclusions: Patients with high NLR and large tumor size are at higher risk of PD during ICI therapy.",

keywords = "head and neck squamous cell carcinoma, immune checkpoint inhibitor, neutrophil-to-lymphocyte ratio, progressive disease, recurrent and/or metastatic",

author = "Jang, \{Seo Yoon\} and Lee, \{Yun Gyoo\} and Chun, \{Sang Hoon\} and Park, \{Ji Hyun\} and Park, \{Keon Uk\} and Hyun Chang and Lee, \{Keun Wook\} and Kim, \{Hye Ryun\} and Shin, \{Seong Hoon\} and An, \{Ho Jung\} and Lee, \{Kyoung Eun\} and Hwang, \{In Gyu\} and Ahn, \{Myung Ju\} and Kim, \{Sung Bae\} and Bhumsuk Keam",

note = "Publisher Copyright: {\textcopyright} 2025 Wiley Periodicals LLC.",

year = "2025",

month = jun,

doi = "10.1002/hed.28071",

language = "English",

volume = "47",

pages = "1621--1630",

journal = "Head and Neck",

issn = "1043-3074",

publisher = "John Wiley \& Sons Inc.",

number = "6",

}

TY - JOUR

T1 - Risk Factors for Progressive Disease After Immune Checkpoint Inhibitor Therapy in Head and Neck Squamous Cell Carcinoma

AU - Jang, Seo Yoon

AU - Lee, Yun Gyoo

AU - Chun, Sang Hoon

AU - Park, Ji Hyun

AU - Park, Keon Uk

AU - Chang, Hyun

AU - Lee, Keun Wook

AU - Kim, Hye Ryun

AU - Shin, Seong Hoon

AU - An, Ho Jung

AU - Lee, Kyoung Eun

AU - Hwang, In Gyu

AU - Ahn, Myung Ju

AU - Kim, Sung Bae

AU - Keam, Bhumsuk

PY - 2025/6

Y1 - 2025/6

N2 - Background: This study analyzed the clinical features of patients with recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC), who developed progressive disease (PD) after immune checkpoint inhibitor (ICI) therapy. Methods: We retrospectively analyzed 256 patients with R/M HNSCC treated with ICIs at 11 medical centers. Associations between the treatment outcomes―best response, overall survival, and progression-free survival―and various clinical factors were analyzed. Results: The objective response rate was 19.5% and PD was observed in 50.4% of the patients. A high neutrophil-to-lymphocyte ratio (NLR > 4; HR, 2.20 [1.28–3.78]) and large tumor size (sum of the target lesions > 40 mm; HR, 1.74 [1.03–2.94]) were significant risk factors for PD. High NLR (HR, 2.00 [1.42–2.82]), poor performance status (ECOG PS 2–3; HR, 3.51 [2.04–6.05]), and large tumor size (HR. 1.63 [1.19–2.24]) were independently associated with poor overall survival. Conclusions: Patients with high NLR and large tumor size are at higher risk of PD during ICI therapy.

AB - Background: This study analyzed the clinical features of patients with recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC), who developed progressive disease (PD) after immune checkpoint inhibitor (ICI) therapy. Methods: We retrospectively analyzed 256 patients with R/M HNSCC treated with ICIs at 11 medical centers. Associations between the treatment outcomes―best response, overall survival, and progression-free survival―and various clinical factors were analyzed. Results: The objective response rate was 19.5% and PD was observed in 50.4% of the patients. A high neutrophil-to-lymphocyte ratio (NLR > 4; HR, 2.20 [1.28–3.78]) and large tumor size (sum of the target lesions > 40 mm; HR, 1.74 [1.03–2.94]) were significant risk factors for PD. High NLR (HR, 2.00 [1.42–2.82]), poor performance status (ECOG PS 2–3; HR, 3.51 [2.04–6.05]), and large tumor size (HR. 1.63 [1.19–2.24]) were independently associated with poor overall survival. Conclusions: Patients with high NLR and large tumor size are at higher risk of PD during ICI therapy.

KW - head and neck squamous cell carcinoma

KW - immune checkpoint inhibitor

KW - neutrophil-to-lymphocyte ratio

KW - progressive disease

KW - recurrent and/or metastatic

UR - https://www.scopus.com/pages/publications/85215599447

U2 - 10.1002/hed.28071

DO - 10.1002/hed.28071

M3 - Article

C2 - 39835419

AN - SCOPUS:85215599447

SN - 1043-3074

VL - 47

SP - 1621

EP - 1630

JO - Head and Neck

JF - Head and Neck

IS - 6

ER -

Risk Factors for Progressive Disease After Immune Checkpoint Inhibitor Therapy in Head and Neck Squamous Cell Carcinoma

Abstract

Bibliographical note

Keywords

Access to Document

Fingerprint

Cite this