Open Access

REVIEW

Efficacy of Immune Checkpoint Inhibitors in the Treatment for Head and Neck Cancer Patients: A Systematic Review and Network Meta-Analysis

Jiao Li^1,2, Nurhayu Ab Rahman^1,3, Suharni Mohamad¹, Guang Yang⁴, Caixia Zhao^2,*

1 School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, 16150, Malaysia
2 Department of Pathology, Changzhi Medical College, Changzhi, 046000, China
3 Oral Medicine and Oral Pathology Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, 16150, Malaysia
4 Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200000, China

* Corresponding Author: Caixia Zhao. Email:

(This article belongs to the Special Issue: Advances in Cancer Immunotherapy)

Oncology Research 2025, 33(9), 2263-2278. https://doi.org/10.32604/or.2025.065911

Received 24 March 2025; Accepted 12 June 2025; Issue published 28 August 2025

Abstract

Objectives: Checkpoint inhibitors have significantly improved outcomes in a number of malignancies. To determine the most effective course of treatment for head and neck squamous cell carcinoma (HNSCC), this systematic review evaluated the efficacy of several therapeutic approaches based on immune checkpoint inhibitors (ICIs). Methods: A comprehensive evaluation of the literature was conducted, looking at randomized controlled trials (RCTs) that were published in Embase, PubMed, and the Cochrane Central Register of Controlled Trials since database establishment. The risk of bias of the enrolled studies was analyzed using The Review Manager (RevMan) 5.4. Using network meta-analyses (NMA), the relative treatment effects on overall survival (OS) and progression-free survival (PFS) from qualifying randomized controlled trials were synthesized and evaluated. Results: Regarding OS, compared with nivolumab plus chemotherapy, chemotherapy (Hazard ratio (HR) = 2.1, 95% Confidence interval (CI): 1.2, 3.4) showed a treatment disadvantage. Meanwhile, nivolumab plus chemotherapy may represent the most efficient (57.89%) and has a lower cost among all the treatments enrolled in this study for advanced HNSCC. Regarding PFS, compared with nivolumab plus ipilimumab, nivolumab plus chemotherapy (HR = 0.4, 95% CI: 0.2, 0.8) showed treatment superiority. Additionally, nivolumab plus chemotherapy (77.18%) has the longest PFS among all interventions. Conclusion: Taking into account OS and PFS, the combination of nivolumab plus chemotherapy may appear to be the most effective option and is associated with a comparatively lower cost among all treatments included in this network meta-analysis, thereby recommending its use as a first-line therapy for HNSCC. Registration: INPLASY (2024070073).

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Supplementary Material

Supplementary Material File

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