Prognostic impact of immune-related adverse events in recurrent or metastatic sinonasal squamous cell carcinoma treated with immune checkpoint inhibitors
摘要
In sinonasal squamous cell carcinoma (SNSCC), evidence regarding the efficacy of immune checkpoint inhibitors (ICIs) and predictive biomarkers remains limited. Immune-related adverse events (irAEs) have been reported as potential indicators of antitumor response and clinical benefit in multiple malignancies; however, their prognostic significance in SNSCC has not been well defined.
MethodsWe retrospectively analyzed 37 patients with recurrent or metastatic (R/M) SNSCC who received ICIs at two institutions. Clinical outcomes, including objective response rate (ORR), overall survival (OS), and progression-free survival (PFS), were assessed. The association between irAE occurrence and OS was evaluated using both landmark analysis and time-dependent Cox proportional hazards models treating irAE occurrence as a time-varying covariate.
ResultsAmong the 37 patients, the ORR was 40.5%, with a median OS of 32.1 months and median PFS of 6.6 months. Twenty-one patients (56.8%) experienced a total of 25 irAEs. In the 3-month landmark analysis, patients with irAEs had significantly better OS and PFS (P = 0.0009 and 0.0008, respectively). However, in the time-dependent Cox model, irAE occurrence was not significantly associated with OS (hazard ratio 0.98, 95% confidence interval 0.38–2.54, P = 0.9627), likely reflecting the influence of late-onset events and the small cohort size.
ConclusionsAlthough irAEs were associated with improved survival in landmark analysis, this association was not confirmed in time-dependent analysis, suggesting a potential influence of immortal time bias. Further prospective studies are warranted.