All authors contributed to the article and approved the submitted version. Conflict of Interest PM has/had a consultant/advisory role for BMS, RocheGenentech, MSD, Novartis, Amgen, Merck Serono, Pierre Fabre, and Incyte. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Publishers Note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. (NMA) of randomized controlled trials (RCTs) in PubMed, ClinicalTrials.gov, Embase, Medline, the Cochrane Central Register of Controlled Trials, Web LY2452473 of Science. Our search identified a total of five randomized controlled trials: Keynote 040, Keynote 048, Eagle, Condor, Checkmate 141. These trials included 3001 patients. Treatment was sub-categorized into PD-L1Cbased, PD-1Cbased, and standard chemotherapy. Treatments were indirectly compared with antiCPD-L1-based therapy. Results The network meta-analysis demonstrated no significant differences in OS between different subgroups except for the metastatic patients in which antiCPD-1-based therapy was associated with significantly less risk of death. Furthermore, antiCPD-1-based therapy appeared to be effective in smoker patients and in human papillomaCnegative (HPV) patients. Conversely, antiCPD-L1-based therapy seems to be better efficient in female patients, in locally recurrent setting and in HPV positive patients. Conclusion This is the first NMA study that aimed to indirectly compare antiCPD-1- and antiCPD-L1-based therapy in HNSCC patients. The results of our NMA could help define a profile of patient responder or resistant to specific classes of immune drugs and can be used to guide/design future studies in the novel scenario of precision immune-oncology. antiCPD-L1-based therapy in HNSCC cancer patients through a systematic literature review (including data from the most recent randomized controlled trials) to provide support for evidence-based treatment decisions. In particular, the effectiveness of ICIs for advanced or metastatic HNSCC is analyzed according to different subgroups of patients (in relation to baseline characteristics) and to the different mechanisms of action of the check-points inhibitory drugs. LY2452473 To the best of our knowledge, this is the first study indirectly comparing the effect of antiCPD-1 and antiCPD-L1 therapy in HNSCC patients. Materials and Methods We performed a systematic literature review and network meta-analysis FGF3 (NMA) of randomized controlled trials (RCTs) in PubMed, ClinicalTrials.gov, Embase, Medline, the Cochrane Central Register of Controlled Trials, and Web of Science. Conference abstracts from the American Society of Clinical Oncology (ASCO) and ESMO were searched independently. Only English language publications were included. The search covered the literature up to July 2017. Search terms included the following: randomized clinical trials, locally advanced and metastatic head and neck cancer, immunotherapy, antiCPD-1, and antiCPD-L1. Search LY2452473 results were restricted to phase II and phase III RCTs. Bibliographies of review articles and editorials were manually searched. The literature review process followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (34). Two authors independently evaluated data LY2452473 from eligible studies, which were then checked by a third author. We performed an NMA for OS data using a random-effects model with a frequentist approach (35, 36) to account for this potential heterogeneity (different study designs, populations, treatment arms, etc.). Treatments were ranked by calculating P scores using the netrank function of the netmeta R-package (37, 38). P scores measure the extent of certainty that a treatment is better than another treatment, averaged over all competing treatments, while taking the LY2452473 precision into account (38). In our study, we used a p 0.05 threshold to judge the statistical significance of our findings, which means that the results are statistically significant if the confidence intervals do not include the value of 1 1 (for HR and relative risk). We also used a p 0.10 threshold as trend because of the reduced number of patients in the various investigated subgroups. The forest plot, with the HR being 1, is indicative of inferior efficacy of all other treatments compared with antiCPD-L1-based therapy. The odds ratio as a simple percent increase or decrease of an event happening, as this value depends on the base-rate, was examined based on the pursuing formula: mathematics xmlns:mml=”http://www.w3.org/1998/Math/MathML” display=”block” id=”M1″ mrow mi P /mi mi t /mi mi r /mi mi e /mi mi a /mi mi t /mi mi m /mi mi e /mi mi n /mi mi t /mi mo = /mo mfrac mrow mi O /mi mi R /mi mo /mo mi P /mi mi c /mi mi o /mi mi n /mi mi t /mi mi r /mi mi o /mi mi l /mi /mrow mrow mn 1 /mn mo + /mo mi O /mi mi R /mi mo /mo mi P /mi mi c /mi mi o /mi mi n /mi mi t /mi mi r /mi mi o /mi mi l /mi mo ? /mo mi P /mi mi c /mi mi o /mi mi n /mi mi t /mi mi r /mi mi o /mi mi l /mi /mrow /mfrac /mrow /mathematics Results A hundred and ninety-eight content were chosen for stage II and III scientific studies antiCPD-1 therapy and 122 for antiCPD-L1 therapy. 3 hundred and thirteen content were analyzed. 3 hundred and six content had been excluded because non randomized studies, review, or not linked to throat and mind cancer tumor. Two further studies had been excluded because linked to immuno-radiotherapy (Amount?1). Our search discovered a complete of five randomized managed studies: Keynote 040, Keynote 048, Eagle, Condor, Checkmate 141. These studies included 3001 sufferers (Table?1S). Treatment was sub-categorized into PD-L1Cbased and PD-1Cbased and the typical chemotherapy (Amount?2). Treatments had been indirectly weighed against antiCPD-L1-structured therapy. The sufferers features, from the discovered RCT, are summarized in Table?1. Open up in another window Amount?1 Diagram of selection practice for trials contained in meta-analysis. Open up in.