Nutritional Status as a Predictive Biomarker for Immunotherapy Outcomes in Advanced Head and Neck Cancer

The association between pretreatment nutritional status and immunotherapy response in patients with advanced head and neck cancer is unclear. We retrospectively analyzed a cohort of 99 patients who underwent treatment with anti-PD-1 or anti-CTLA-4 antibodies (or both) for stage IV HNSCC between 2014 and 2020 at the Johns Hopkins Hospital. Patient demographics and clinical characteristics were retrieved from electronic medical records. Baseline prognostic nutritional index (PNI) scores and pretreatment body mass index (BMI) trends were calculated. Associations between PNI and BMI were correlated with overall survival (OS), progression-free survival (PFS), and immunotherapy response. In univariate analysis, there was a significant correlation between OS and PFS with baseline PNI (OS: HR: 0.464; 95% CI: 0.265–0.814; PFS: p = 0.007 and HR: 0.525; 95% CI: 0.341–0.808; p = 0.003). Poor OS was also associated with a greater decrease in pretreatment BMI trend (HR: 0.42; 95% CI: 0.229–0.77; p = 0.005). In multivariate analysis, baseline PNI but not BMI trend was significantly associated with OS and PFS (OS: log (HR) = −0.79, CI: −1.6, −0.03, p = 0.041; PFS: log (HR) = −0.78, CI: −1.4, −0.18, p = 0.011). In conclusion, poor pretreatment nutritional status is associated with negative post-immunotherapy outcomes.

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Nutritional status as a prognostic factor in advanced head and neck cancer

Clinical Otolaryngology ◽

10.1046/j.1365-2273.1998.0165g.x ◽

1998 ◽

Vol 23 (4) ◽

pp. 376-376

Author(s):

Quak ◽

Van Bokhorst ◽

Klop ◽

Van Leeuwen ◽

Snow

Keyword(s):

Head And Neck Cancer ◽

Prognostic Factor ◽

Nutritional Status ◽

Head And Neck ◽

Neck Cancer ◽

Advanced Head

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Objective evaluation of nutritional status using the prognostic nutritional index during and after chemoradiotherapy in Japanese patients with head and neck cancer: a retrospective study

European Journal of Hospital Pharmacy ◽

10.1136/ejhpharm-2019-001979 ◽

2019 ◽

pp. ejhpharm-2019-001979

Author(s):

Daichiro Fujiwara ◽

Masanobu Tsubaki ◽

Tomoya Takeda ◽

Makoto Miura ◽

Shozo Nishida ◽

...

Keyword(s):

Head And Neck Cancer ◽

Retrospective Study ◽

Nutritional Status ◽

Head And Neck ◽

Neck Cancer ◽

Prognostic Nutritional Index ◽

Japanese Patients ◽

Objective Evaluation ◽

Nutritional Index

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Elective gastrostomy, nutritional status and quality of life in advanced head and neck cancer patients receiving chemoradiotherapy

ANZ Journal of Surgery ◽

10.1111/j.1445-2197.2009.05056.x ◽

2009 ◽

Vol 79 (10) ◽

pp. 713-718 ◽

Cited By ~ 45

Author(s):

Randall P. Morton ◽

Victoria L. Crowder ◽

Robert Mawdsley ◽

Esther Ong ◽

Mark Izzard

Keyword(s):

Quality Of Life ◽

Head And Neck Cancer ◽

Nutritional Status ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Advanced Head

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Predicitve factors of cisplatin (CDDP) discontinuation in concurrent chemoradiotherapy (CCRT) to locally advanced head and neck cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e17006 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e17006-e17006

Author(s):

Kenji Nakano ◽

Yasuyoshi Sato ◽

Yukiko Sato ◽

Takashi Toshiyasu ◽

Takao Asari ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Renal Dysfunction ◽

Cancer Patients ◽

Neck Cancer ◽

Odds Ratio ◽

Locally Advanced ◽

Stage Iv ◽

High Dose ◽

Advanced Head

e17006 Background: CCRT is a standard therapy for locally advanced head and neck cancer patients, but some patients have intolerance to high dose density of CDDP. Predictive factors for CDDP discontinuation need to be investigated for making appropriate treatment decisions. Methods: We retrospectively analyzed nonmetastatic head and neck cancer patients treated with CCRT with CDDP (80 mg/m2 per 3 weeks) from November 2005 to April 2012 in our institute. Radiation therapy was performed as three-dimensional radiotherapy or intensity-modified radiotherapy (IMRT). Results: A total of 164 patients received CCRT, of which 89 (54 %) were Stage IV;. Primary sites were as follows; oral cavity 7, oropharynx 52, hypopharynx 53, larynx 14, nasopharynx 30, paranasal sinus/nasal cavity 3, and unknown primary 5. IMRT was performed to 54 (33 %) patients. Median follow-up time was 19 months (range 1-69 months); 1-year overall survival (OS) and progression free survival (PFS) were 90 % and 78 %. Non-Stage IV; and high creatinine clearance (>70 ml/min) were associated with longer OS in Cox proportional hazard model. As for CDDP treatment, 75 (46 %) patients completed 3 cycles of CDDP, 69 (42 %) patients received 2 cycles, and 20 (12 %) patients received only 1 cycle. The main reasons for CDDP discontinuation were infection (24 patients) and renal dysfunction (18 patients). In logistic regression analysis, male sex, younger age (< 61 years) and high body mass index (BMI) (>25) were associated with 3 cycles completion of CDDP statistically significantly (p = .002, odds ratio 6.622; p = .006, odds ratio 2.602; p = .035, odds ratio 2.655, respectively). Conclusions: In CCRT to head and neck cancer patients, infection and renal dysfunction were the main reasons for CDDP discontinuation. Sex, age and BMI could be predictive of CDDP completion/discontinuation.

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Determining Malnutrition Assessment Criteria to Predict One-Year Mortality for Locally Advanced Head and Neck Cancer Patients Undergoing Concurrent Chemoradiotherapy

Nutrients ◽

10.3390/nu12030836 ◽

2020 ◽

Vol 12 (3) ◽

pp. 836 ◽

Cited By ~ 1

Author(s):

Hang Huong Ling ◽

Kun-Yun Yeh ◽

Shu-Hang Ng ◽

Cheng-Hsu Wang ◽

Chien-Hong Lai ◽

...

Keyword(s):

Head And Neck Cancer ◽

Mortality Rate ◽

Head And Neck ◽

Neck Cancer ◽

Locally Advanced ◽

Prognostic Nutritional Index ◽

Assessment Methods ◽

Advanced Head ◽

One Year ◽

The Impact

Study on the impact of pretreatment malnutrition on treatment outcomes in locally advanced head and neck cancer (LAHNC) patients is still lacking. We prospectively collected various malnutrition assessment methods including nutrition indexes, inflammatory biomarkers, and lean body mass index (LBMI) data before treatments. The one year mortality rate was assessed, and the factors associated with this outcome were investigated. Furthermore, the association between malnutrition assessment methods was examined. A total of 113 patients were enrolled. By prognostic stratification based on the prognostic nutritional index (PNI) and platelet-to-lymphocyte ratio (PLR) combination, the low PNI/high PLR group had highest and the high PNI/low PLR group had the lowest mortality rate. Furthermore, the PNI was positively correlated with the LBMI, and the PLR was inversely correlated with the LBMI. PNI and PLR were found to be independent prognostic factors of one year mortality and also associated with the loss of muscle.

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Neoadjuvant chemotherapy consisting of cisplatin and continuous infusions of bleomycin and 5-fluorouracil for advanced head and neck cancer. The need for a new stratification for stage IV (MO) disease

Cancer ◽

10.1002/1097-0142(19911115)68:10<2109::aid-cncr2820681004>3.0.co;2-m ◽

1991 ◽

Vol 68 (10) ◽

pp. 2109-2119 ◽

Cited By ~ 13

Author(s):

Gonzalo Recondo ◽

Esteban Cvitkovic ◽

Nacer Azli ◽

Eduardo Tellez Bernal ◽

Florent De Vathaire ◽

...

Keyword(s):

Head And Neck Cancer ◽

Neoadjuvant Chemotherapy ◽

Head And Neck ◽

Neck Cancer ◽

Stage Iv ◽

Advanced Head

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“CLINICALASSESSMENT OF TREATMENT RELATED TOXICITY AND RESPONSE BY CONCOMITANT CHEMORADIATION THERAPY IN LOCALLY ADVANCED HEAD AND NECK CARCINOMA”

10.36106/ijsr/0902974 ◽

2021 ◽

pp. 79-81

Author(s):

Swapan Kumar Mallick ◽

Rinki Saha

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Treatment Options ◽

Locally Advanced ◽

Stage Iv ◽

Head And Neck Carcinoma ◽

Complete Response ◽

Advanced Head

Introduction: Head and neck cancer is the commonest malignancy in India. Most of the cases present are at a locally advanced stage. Concurrent chemo radiotherapy is one of the treatment options in locally advanced Head & Neck Cancer patients. Materials & Methods: Locally advanced head and neck cancer patients attending the Out Patient Department of Radiotherapy from May 2018 to February 2020. Patients were treated with concurrent chemoradiation and followed for a minimum period of 9 months. Results: On analysing the pattern of response, it was noted that, in the chemoradiation complete response was seen in 20 patients (66.66%), partial response in 6 patients (20%), stable disease in 2 patients (6.66%) and progressive disease in 1 patient (3.33%). In our study, complete Response in case of Stage III was seen in 18 patients and other form of response was seen in 3 patients . In case of Stage IV A and IV B , Complete Response in 2 patients and other form of response was in 6 patients respectively. Haematological toxicities like neutropenia (3.3%), thrombocytopenia (0%) and anaemia (3.3%) were seen. Acute toxicities like oral mucositis and skin reaction were observed 10% in both the cases. Conclusions: The present study, Concomitant chemoradiotherapy improved overall survival and locoregional control. Preservation of function is a major endpoint of interest.

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