Time toxicity of nivolumab in metastatic head and neck squamous cell carcinoma patients: a single-institution experience
Bibliographic record
Abstract
BACKGROUND: Treatment of platinum-refractory recurrent and metastatic head and neck squamous cell carcinoma (r/mHNSCC) involves immune-checkpoint inhibitors. Time toxicity (TT) is an emerging metric with implications for patient quality of life and decision-making. We sought to evaluate TT associated with nivolumab in these patients. METHODS: This is a retrospective single-institution review of patients with platinum-refractory r/mHNSCC seen at an academic cancer center between 1 January 2018 to 31 December 2022 in Ontario, Canada. Primary outcome is TT, defined as any number of days spent undergoing cancer-related activities. RESULTS: Of 56 patients evaluated, median age was 63 years (33-85) and 84% were male. Median overall survival (OS) and grade 3 immune-toxicities were 7.6 months and 6.2%, respectively. Median TT was 24 days (1-109), accounting for 7.6% of OS. TT accounted for 14.9% of OS in poor responders. TT accounted for only 4-6% for patients who survived more than a year. CONCLUSIONS: Our study provides an important and underexplored patient-centered metric in TT, especially in the context of incurable HNSCC with abysmal survival outcome. Our findings suggest that TT varies significantly between responders and non-responders. Duration of TT should be discussed with patients in shared decision-making when discussing palliative nivolumab.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".