Immunotherapy with Chemotherapy in Recurrent or Metastatic Maxillary Sinus Squamous Cell Carcinoma: A Real-world Study in China.

BACKGROUND

Patients with Recurrent or Metastatic Maxillary Sinus Squamous Cell Carcinoma (R/M MSSCC) generally have a poor prognosis. Traditional chemotherapy has limited efficacy. In real-world practice, there is no data about the efficacy and safety of immunotherapy combined with chemotherapy in these patients.

OBJECTIVE

This study aimed to evaluate the efficacy and safety of immunotherapy combined with chemotherapy for patients with unresectable R/M MSSCC in a real-world setting.

METHODS

We included 15 R/M MSSCC patients treated at Beijing Tongren Hospital from January 2021 to December 2024. All patients received PD-1 inhibitors combined with chemotherapy. We collected and analyzed clinical information and survival data of all patients.

RESULTS

The Objective Response Rate (ORR) was 26.7%, and the Disease Control Rate (DCR) was 86.7%. The median Progression-Free Survival (PFS) was 5.1 months (95% CI 0.26-17.27), and the median Overall Survival (OS) was 7.8 months (95% CI 0.44-10.23). Compared with patients with PD-L1 CPS < 20, patients with CPS ≥20 had a longer median PFS (14.1 months vs.3.9 months, p=0.031, HR 0.223, 95%CI 0.040-1.264). The most frequent grade 1/2 Adverse Events (AEs) included: loss of appetite (15/15, 100%), alopecia (13/15, 86%), anemia (10/15, 67%), peripheral neurotoxicity (10/15, 67%), and leukopenia (8/15, 53%). Only one person experienced a grade 4 AE, which was chemotherapy-induced neutropenia. The most common immune-related AE was hypothyroidism (3/15, 20%). No serious immune-related adverse events were observed.

DISCUSSION: This study shows that PD-1 inhibitors combined with chemotherapy are a feasible and promising treatment strategy for recurrent/metastatic MSSCC. Most importantly, the results suggest that PD-L1 CPS has predictive value in this anatomical subtype. Patients with CPS ≥20 showed a significant survival benefit.

CONCLUSION

In real-world practice, PD-1 inhibitors combined with chemotherapy are an effective and safe treatment option for recurrent/metastatic R/M MSSCC.