PET-CT, genomic profile linked to survival in head and neck cancer patients on immunotherapy

Maximum standardized uptake value (SUVmax) on positron emission tomography–computed tomography (PET-CT) has been previously reported as a potential clinical predictor for survival outcome among patients with HNSCC.

Systemic and tumor inflammation with laboratory and tumor metabolic imaging tests may provide useful prognostic information for head and neck squamous cell cancer (HNSCC) patients treated with immune checkpoint inhibitor (ICI) drugs, suggests a study published in the JAMA Otolaryngology- Head & Neck Surgery by a team of researchers from the Department of Surgery, Head & Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York.

Conall W. R. Fitzgerald and colleagues set up an objective to analyze the association between SUVmax on PET-CT and survival in patients with head and neck cancer receiving ICI therapies.

The authors analyzed clinical and genomic data from patients treated with ICI for HNSCC. Patients who received PET-CT imaging within 180 days prior to ICI start date were included, and SUVmax was categorized as above or below the median. Of 143 patients with mucosal HNSCC treated with ICI, 98 met inclusion criteria for analysis.

Other clinical and genomic covariates with prior evidence of prognostic value were analyzed, including pretreatment peripheral blood neutrophil-to-lymphocyte ratio (NLR) and tumor mutation burden (TMB), as assessed using Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets (MSK-IMPACT), a targeted genomic sequencing panel of 341-468 genes.

The outcomes analyzed were overall and progression-free survival, and response to treatment was assessed using RECIST version 1.1 criteria and the data drawn was analyzed.

The results of the study showed that the median SUVmax was 11, and was localized to the head and neck in 47 patients (48.0%); lung, 30 (30.6%); bone, 11 (11.2%); and gastrointestinal tract/liver, 10 (10.2%).

The site of SUVmax was at a primary recurrence site rather than metastatic site in 31 patients (31.6%). However, in patients with metastases, the mean number of metastatic sites was 1.9. Immune checkpoint inhibitor treatment was given for recurrent rather than metastatic disease in 19 patients. Average time from PET-CT to start of ICI therapy was 52 days.

10.1001/jamaoto.2021.1763