Enhanced ICI Response in High-TMB HNSCC: Meta-Analysis

Tumor mutational burden (TMB) has emerged as a reliable predictor of immune checkpoint inhibitor (ICI) response across diverse cancers. Despite this, the specific role of TMB in head and neck squamous cell carcinoma (HNSCC) remains unexplored.

Notably, HNSCC patients (pts) exhibit limited responsiveness to ICIs, underscoring the unmet need for predictive biomarkers to refine patient selection criteria and enhance the clinical benefits of ICI treatment. Juan P. Rodrigo and his team aimed to address this critical gap in understanding.

Researchers performed an inclusive analysis following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. HNSCC cohort studies were meticulously selected based on criteria, including the evaluation of TMB before ICI treatment, availability of TMB cutoff values, and assessment of TMB’s prognostic value through time-to-event survival analysis. Out of the 1960 articles screened, 11 met the inclusion criteria, encompassing data from 1200 HNSCC pts.

The analysis revealed compelling results, indicating that pts with high TMB demonstrated a significantly enhanced overall response rate (OR = 2.62; 95% CI 1.74–3.94; P < 0.0001) following ICI treatment. Furthermore, this subgroup exhibited a notable survival advantage (HR = 0.53; 95% CI 0.39–0.71; P < 0.0001) after ICI treatment.

The study concluded that, for the first time, a meta-analysis established a heightened response and clinical benefit in HNSCC pts with high TMB undergoing ICI therapy.

Source: https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-024-04937-x

Rodrigo, J.P., Sánchez-Canteli, M., Otero-Rosales, M. et al. Tumor mutational burden predictability in head and neck squamous cell carcinoma patients treated with immunotherapy: systematic review and meta-analysis. J Transl Med 22, 135 (2024). https://doi.org/10.1186/s12967-024-04937-x