Impact of comorbidities on outcomes in patients with advanced head and neck cancer undergoing immunotherapy

Meytal Guller; Dylan J. Cooper; Hosam Alkhatib; Aditya Suru; Angelo Blancaflor; Christopher A. Maroun; Tristan Tham; Hailey Allen; Eden Mazzara; Jerin Thomas; Neha Amin; Evan Wu; David W. Eisele; Carole Fakhry; Drew Pardoll; Tanguy Y. Seiwert; Gangcai Zhu; Rajarsi Mandal

doi:10.1002/hed.27502

Impact of comorbidities on outcomes in patients with advanced head and neck cancer undergoing immunotherapy

Meytal Guller, Dylan J. Cooper, Hosam Alkhatib, Aditya Suru, Angelo Blancaflor, Christopher A. Maroun, Tristan Tham, Hailey Allen, Eden Mazzara, Jerin Thomas, Neha Amin, Evan Wu, David W. Eisele, Carole Fakhry, Drew Pardoll, Tanguy Y. Seiwert, Gangcai Zhu, Rajarsi Mandal

School of Medicine

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

Abstract

Objectives: To explore the impact of pre-existing comorbidities on immunotherapy response, overall and progression-free survival, and immune-related adverse events (irAEs) of patients with advanced head and neck cancer (HNC) treated with immunotherapy. Patients and methods: Ninety-three patients treated with immunotherapy were identified and stratified into comorbidity absent or present (CCI < 1 and CCI ≥ 1, respectively) cohorts, and clinical outcomes were compared between these two groups. Results: Patients with no comorbidities had longer overall survival (aHR = 2.74, 95% CI [1.18, 6.40], p = 0.02) and progression-free survival (aHR = 2.07, 95% CI [1.03, 4.16], p = 0.04) and a higher tumor response rate (32% in CCI < 1 vs. 14% in CC ≥ 1, p = 0.05). Risk for irAEs was higher in the comorbidity absent group (p = 0.05). Conclusion: Comorbidity should be considered as a significant prognostic factor in clinical decision-making for patients with advanced HNC undergoing immunotherapy.

Original language	English (US)
Pages (from-to)	2789-2797
Number of pages	9
Journal	Head and Neck
Volume	45
Issue number	11
DOIs	https://doi.org/10.1002/hed.27502
State	Published - Nov 2023

Keywords

Charlson comorbidity index
advanced head and neck cancer
comorbidities
comorbidity
immunotherapy

ASJC Scopus subject areas

Otorhinolaryngology

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10.1002/hed.27502

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Guller, M., Cooper, D. J., Alkhatib, H., Suru, A., Blancaflor, A., Maroun, C. A., Tham, T., Allen, H., Mazzara, E., Thomas, J., Amin, N., Wu, E., Eisele, D. W., Fakhry, C., Pardoll, D., Seiwert, T. Y., Zhu, G., & Mandal, R. (2023). Impact of comorbidities on outcomes in patients with advanced head and neck cancer undergoing immunotherapy. Head and Neck, 45(11), 2789-2797. https://doi.org/10.1002/hed.27502

Guller, M, Cooper, DJ, Alkhatib, H, Suru, A, Blancaflor, A, Maroun, CA, Tham, T, Allen, H, Mazzara, E, Thomas, J, Amin, N, Wu, E, Eisele, DW , Fakhry, C , Pardoll, D , Seiwert, TY, Zhu, G & Mandal, R 2023, 'Impact of comorbidities on outcomes in patients with advanced head and neck cancer undergoing immunotherapy', Head and Neck, vol. 45, no. 11, pp. 2789-2797. https://doi.org/10.1002/hed.27502

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title = "Impact of comorbidities on outcomes in patients with advanced head and neck cancer undergoing immunotherapy",

abstract = "Objectives: To explore the impact of pre-existing comorbidities on immunotherapy response, overall and progression-free survival, and immune-related adverse events (irAEs) of patients with advanced head and neck cancer (HNC) treated with immunotherapy. Patients and methods: Ninety-three patients treated with immunotherapy were identified and stratified into comorbidity absent or present (CCI < 1 and CCI ≥ 1, respectively) cohorts, and clinical outcomes were compared between these two groups. Results: Patients with no comorbidities had longer overall survival (aHR = 2.74, 95% CI [1.18, 6.40], p = 0.02) and progression-free survival (aHR = 2.07, 95% CI [1.03, 4.16], p = 0.04) and a higher tumor response rate (32% in CCI < 1 vs. 14% in CC ≥ 1, p = 0.05). Risk for irAEs was higher in the comorbidity absent group (p = 0.05). Conclusion: Comorbidity should be considered as a significant prognostic factor in clinical decision-making for patients with advanced HNC undergoing immunotherapy.",

keywords = "Charlson comorbidity index, advanced head and neck cancer, comorbidities, comorbidity, immunotherapy",

author = "Meytal Guller and Cooper, {Dylan J.} and Hosam Alkhatib and Aditya Suru and Angelo Blancaflor and Maroun, {Christopher A.} and Tristan Tham and Hailey Allen and Eden Mazzara and Jerin Thomas and Neha Amin and Evan Wu and Eisele, {David W.} and Carole Fakhry and Drew Pardoll and Seiwert, {Tanguy Y.} and Gangcai Zhu and Rajarsi Mandal",

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year = "2023",

month = nov,

doi = "10.1002/hed.27502",

language = "English (US)",

volume = "45",

pages = "2789--2797",

journal = "Head and Neck",

issn = "1043-3074",

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T1 - Impact of comorbidities on outcomes in patients with advanced head and neck cancer undergoing immunotherapy

AU - Guller, Meytal

AU - Cooper, Dylan J.

AU - Alkhatib, Hosam

AU - Suru, Aditya

AU - Blancaflor, Angelo

AU - Maroun, Christopher A.

AU - Tham, Tristan

AU - Allen, Hailey

AU - Mazzara, Eden

AU - Thomas, Jerin

AU - Amin, Neha

AU - Wu, Evan

AU - Eisele, David W.

AU - Fakhry, Carole

AU - Pardoll, Drew

AU - Seiwert, Tanguy Y.

AU - Zhu, Gangcai

AU - Mandal, Rajarsi

PY - 2023/11

Y1 - 2023/11

N2 - Objectives: To explore the impact of pre-existing comorbidities on immunotherapy response, overall and progression-free survival, and immune-related adverse events (irAEs) of patients with advanced head and neck cancer (HNC) treated with immunotherapy. Patients and methods: Ninety-three patients treated with immunotherapy were identified and stratified into comorbidity absent or present (CCI < 1 and CCI ≥ 1, respectively) cohorts, and clinical outcomes were compared between these two groups. Results: Patients with no comorbidities had longer overall survival (aHR = 2.74, 95% CI [1.18, 6.40], p = 0.02) and progression-free survival (aHR = 2.07, 95% CI [1.03, 4.16], p = 0.04) and a higher tumor response rate (32% in CCI < 1 vs. 14% in CC ≥ 1, p = 0.05). Risk for irAEs was higher in the comorbidity absent group (p = 0.05). Conclusion: Comorbidity should be considered as a significant prognostic factor in clinical decision-making for patients with advanced HNC undergoing immunotherapy.

AB - Objectives: To explore the impact of pre-existing comorbidities on immunotherapy response, overall and progression-free survival, and immune-related adverse events (irAEs) of patients with advanced head and neck cancer (HNC) treated with immunotherapy. Patients and methods: Ninety-three patients treated with immunotherapy were identified and stratified into comorbidity absent or present (CCI < 1 and CCI ≥ 1, respectively) cohorts, and clinical outcomes were compared between these two groups. Results: Patients with no comorbidities had longer overall survival (aHR = 2.74, 95% CI [1.18, 6.40], p = 0.02) and progression-free survival (aHR = 2.07, 95% CI [1.03, 4.16], p = 0.04) and a higher tumor response rate (32% in CCI < 1 vs. 14% in CC ≥ 1, p = 0.05). Risk for irAEs was higher in the comorbidity absent group (p = 0.05). Conclusion: Comorbidity should be considered as a significant prognostic factor in clinical decision-making for patients with advanced HNC undergoing immunotherapy.

KW - Charlson comorbidity index

KW - advanced head and neck cancer

KW - comorbidities

KW - comorbidity

KW - immunotherapy

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Impact of comorbidities on outcomes in patients with advanced head and neck cancer undergoing immunotherapy

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Keywords

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