Neutrophil to lymphocyte ratio and peripheral blood biomarkers correlate with survival outcomes but not response among head and neck and salivary cancer treated with pembrolizumab and vorinostat

Cassie Pan; Qian Vicky Wu; Jenna Voutsinas; Jeffrey J Houlton; Brittany Barber; Neal Futran; George E Laramore; Jay J Liao; Upendra Parvathaneni; Renato G Martins; Jonathan R Fromm; Cristina P Rodriguez

doi:10.1002/hed.27252

Neutrophil to lymphocyte ratio and peripheral blood biomarkers correlate with survival outcomes but not response among head and neck and salivary cancer treated with pembrolizumab and vorinostat

Head Neck. 2023 Feb;45(2):391-397. doi: 10.1002/hed.27252. Epub 2022 Nov 22.

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA.
² Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
³ Department of Radiation Oncology, University of Washington, Seattle, Washington, USA.
⁴ Division of Hematology, Oncology and Palliative Care, Department of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.
⁵ Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.
⁶ Division of Oncology, Department of Medicine, University of Washington, Seattle, Washington, USA.

Abstract

Background: Associations between peripheral blood biomarkers and oncologic outcomes were explored in recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HN) and salivary gland cancer (SGC) treated with pembrolizumab and vorinostat on a phase II trial (NCT02538510).

Experimental design: Twenty-five HN and 25 SGCs were treated with pembrolizumab and vorinostat. Baseline peripheral blood was available in 21 HN and 20 SGCs and evaluated for associations with grade ≥3 adverse events (G ≥ 3AE) by CTCAEv4, objective response rate (ORR), overall survival (OS), and progression-free survival (PFS).

Results: Higher pretreatment neutrophil-to-lymphocyte ratio (NLR) and neutrophils, as well as lower pretreatment lymphocytes and T helper cells correlated with worse OS and PFS. Higher NLR further predicted increased rates of G ≥ 3AEs. No correlations with ORR were observed.

Conclusions: In a prospectively evaluated cohort of HN and SGCs treated with pembrolizumab and vorinostat, we observed novel associations between peripheral blood biomarkers and oncologic outcomes and toxicities.

Keywords: head and neck cancer; immunotherapy; pembrolizumab; peripheral blood biomarkers; salivary gland cancer.

Publication types

Clinical Trial, Phase II
Research Support, N.I.H., Extramural

MeSH terms

Biomarkers
Head and Neck Neoplasms* / drug therapy
Humans
Lymphocytes / pathology
Neoplasm Recurrence, Local / pathology
Neutrophils* / pathology
Prognosis
Squamous Cell Carcinoma of Head and Neck
Vorinostat

Substances

Biomarkers
pembrolizumab
Vorinostat

Associated data

ClinicalTrials.gov/NCT02538510

Grants and funding

T32 DC000018/DC/NIDCD NIH HHS/United States