SynthesisJournal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology2026
Adjuvant Immune Checkpoint Inhibitors in Head and Neck Cancer: A Meta-Analysis of Phase III Trials.
Synthesis in Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis meta-analysis evaluates the efficacy and safety of adjuvant immune checkpoint inhibitors (ICIs), specifically nivolumab and pembrolizumab, when combined with standard chemoradiotherapy (CRT) in patients with resected locally advanced head and neck squamous cell carcinoma (LA-HNSCC). Despite the potential of ICIs in improving survival outcomes, variability in patient responses and adverse event profiles remains a challenge.
methodsData were pooled from two Phase III randomized controlled trials, NIVOPOSTOP and KEYNOTE-689, involving 1394 high-risk patients with advanced disease, positive surgical margins, and extranodal extension. The primary endpoints were disease-free survival (DFS) and overall survival (OS). Secondary endpoints included treatment-related adverse events. Hazard ratios (HR) and corresponding 95% confidence intervals (CI) were calculated for survival outcomes, and risk ratios (RR) for adverse events. Subgroup analyzes were performed based on PD-L1 expression.
resultsThe addition of ICIs to CRT resulted in significant improvements in DFS (HR: 0.75, 95% CI: 0.65-0.87) and OS (HR: 0.74, 95% CI: 0.65-0.85), representing a 25% reduction in the risk of recurrence and a 26% reduction in the risk of death. Subgroup analysis showed a greater benefit for patients with PD-L1 expression (CPS ≥ 1), with a pooled HR of 0.66 (95% CI: 0.49-0.88). Adverse events were more frequent with ICIs, with 81% of patients reporting any-grade adverse events and 42.9%-44.6% experiencing Grade 3 or higher events. The incidence of immune-related adverse events was significantly higher in the immunotherapy groups (p = 0.008), with notable increases in hypothyroidism and immune-mediated toxicities. Treatment discontinuation due to adverse events occurred in 12.4%-17.7% of patients.
conclusionsAdjuvant ICIs significantly improve survival outcomes in high-risk patients with resected LA-HNSCC, especially in case of CPS ≥ 1, but are associated with an increased risk of adverse events, particularly immune-related toxicities. These findings support the integration of ICIs into postsurgical treatment regimens, though careful patient selection and monitoring are essential. Further research is needed to optimize treatment regimens and manage toxicities effectively.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.