PD-1/PD-L1 Expression and consecutive therapy possibilities in a real life consecutive head and neck squamous cell carcinoma (HNSCC) cohort

Introduction Immunotherapy is a developing therapeutic option especially for aged HNSCC patients. Unclear is the in-lable likelihood to treat with PD-1/PD-L1 inhibitors for several tumor sublocations, as well as for future clinical studies, the possible recruitment percentage if immunotherapy is given as neo-adjuvant treatment option.

Methods PD-1/PD-L1 expression was determined in all consecutive patients with newly diagnosed HNSCC. Both TP- and CP-Score using standard assays as well as other patient- and tumor-derived data were prospectively collected.

Results 179 (142♂,47♀; mean age 73±20 years) patients showed a mean %TPS expression of 3±4 (Median 8) with no expression in 26 cases. Using a cut-off value of 5% expression, 52.9% of patients were positively tested. Based on the TPS score, 68.8% of patients were theoretically suitable for nivolumab.

Mean CPS was 45±49 (median 20) with 3 cases being without any expression. Using a cut-off value of 5%, 123 patients (73.2%) were positive and 50.5% showed 20% TPS enabling a possible therapy with pembrolizumab. Influence of age, gender, TNM classification and tumor localisation was studied as possible further influencing factors.

Discussion Our cohort indicates an increasing number of patients with HNSCC at older age presenting a treatment challenge due to limited possibility to treat with chemotherapy due to comorbidities. PD-L1 expression levels in HNSCC varied in the literature between 27%-78% in clinical trials supporting our results.

Conclusion In our aged cohort, PD-1/PD-L1 expression showed a relatively high precentage of possible immunotherapy with both nivolumab and pembrolizumab.

Publication History

Article published online:
24 May 2022