Durable complete remission with local therapies after neoadjuvant and adjuvant nivolumab in recurrent/metastatic head and neck cancer

• Published in: Anti-cancer drugs Vol. 34; no. 5; p. 695
• Main Authors: Cabezas-Camarero, Santiago, Iglesias-Moreno, María Cruz, Cerezo Druet, Elena, Sotelo, Miguel J, Merino-Menéndez, Salomé, Cabrera-Martín, María Nieves, Plaza-Hernández, José Carlos, Pérez-Segura, Pedro
• Format: Journal Article
• Language: English
• Published: England 01.06.2023
• Subjects: Head and Neck Neoplasms - drug therapy; Humans; Neoadjuvant Therapy; Neoplasm Recurrence, Local - drug therapy; Nivolumab - therapeutic use; Platinum; Squamous Cell Carcinoma of Head and Neck - drug therapy
• ISSN: 1473-5741
• DOI: 10.1097/CAD.0000000000001422

Up to 10-15% of patients with first-line recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) present with platinum-refractory disease. The anti-PD1 nivolumab is the first therapeutic option in this setting achieving a 19.2% objective response rate and a 7.7-month median overall survival (OS). Given the poor prognosis of platinum-refractory patients, those showing slow progressive disease with no functional status deterioration should maintain nivolumab beyond progression in the absence of severe or unmanageable toxicities. Another strategy is to use local therapies such as radiotherapy and surgical tumor resection in cases of oligometastatic or oligoprogressive disease. Both strategies may significantly improve disease control and OS in these populations. We present the case of a patient with platinum-refractory disease treated with first-line nivolumab beyond progression who achieved a durable complete response after palliative radiation and surgical resection of five tumor lesions. To our knowledge, this is the first reported case of an R/M HNSCC treated with such a strategy outside a clinical trial and contributes to the evidence for combining anti-PD1 agents and local therapies in selected patients with R/M HNSCC.