Comparative pooled analysis of targeted therapies,or immunotherapy plus chemotherapies versus conventional platinum-based therapies or single-agent immunotherapies in recurrent or metastatic head and neck squamous cell carcinoma: A systematic review and meta-analysis

Abstract

Background

Treatment selection for recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) remains complex due to varying clinical outcomes across different therapeutic approaches. This systematic review and meta-analysis aim to compare the efficacy and safety of combination therapies (targeted therapies or immunotherapy plus chemotherapy) versus conventional platinum-based chemotherapy or single-agent immunotherapy.

Methods

A comprehensive literature search was conducted across MEDLINE (PubMed), Cochrane Library and ClinicalTrials.gov. This meta-analysis included articles published from January 2000 to December 2024. Only randomized controlled trials (RCTs) evaluating these treatment strategies in R/M HNSCC patients were included. Trials exclusively focused on nasopharyngeal carcinoma or non-randomized studies with insufficient data were excluded.

Results

After screening for 645 records, seven RCTs involving 2505 patients were analyzed. Combination therapies demonstrated superior survival outcomes compared to conventional approaches. Pooled analysis showed a significant improvement in progression-free survival (PFS) (HR: 0.84, 95% CI: 0.79–0.90, p < 0.0001) and a trend toward improved overall survival (OS) (HR: 0.92, 95% CI: 0.86–1.00, p = 0.05).

Conclusion

This meta-analysis supports the use of targeted therapies or immunotherapy plus chemotherapy as a preferred first-line treatment option for R/M HNSCC due to their favorable efficacy and safety profile. Further clinical investigations are warranted to refine treatment strategies and optimize patient outcomes.

Keywords

Recurrent or metastatic HNSCC targeted therapy immunotherapy chemotherapy platinum-Based chemotherapy randomized controlled trials evidence-based medicine

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