Complete remission of an early-stage laryngeal cancer under combined pembrolizumab and chemotherapy treatment of a synchronous lung adenocarcinoma

Abstract

Background Anti-PD1-Checkpoint inhibition (CI) is an established treatment of recurrent and/or metastatic head and neck cancer. A potential benefit from CI in early-stage disease that is usually treated by radiation or surgery has not been investigated so far and is currently not addressed in clinical trials. Case presentation A 58-year-old man was diagnosed with a cT2 supraglottic laryngeal cancer and a synchronous metastasized adenocarcinoma of the lung. As the patient refused any treatment of his laryngeal cancer, he received combined immune-chemotherapy according to the KEYNOTE-189 protocol. After 4 cycles of pembrolizumab/carboplatin/pemetrexed, the patient showed a complete remission of his laryngeal cancer with a clear shrinkage of the mediastinal and hilar lung cancer metastases. After 21 cycles of maintenance therapy, the lung adenocarcinoma shows a stable disease status with no signs of any residual or recurrent laryngeal cancer. Conclusions Anti-PD1-CI may be a treatment option also for early-stage HNSCC with excellent functional outcome when established therapies are not available. Graphical Abstract

Integrative Spatial Analysis of H&E and IHC Images Identifies Prognostic Immune Subtypes Correlated with Progression-Free Survival in Human Papillomavirus (HPV)-Related Oropharyngeal Squamous Cell Carcinoma

“…HPV(+) OPSCC tumors often exhibit increased infiltration of cytotoxic T lymphocytes (CTLs) and higher levels of immune checkpoint proteins, such as PD-L1 [24]. This immune-active TME has paved the way for the successful use of immune checkpoint inhibitors (ICIs) in the treatment of HPV(+) HNSCC [25,26,27]. Unfortunately, only 15-20% of patients with HNSCC benefit from ICI, and this poor outcome is increasingly ascribed to the peculiar characteristics of the TIME [28].…”

Integrative Spatial Analysis of H&E and IHC Images Identifies Prognostic Immune Subtypes Correlated with Progression-Free Survival in Human Papillomavirus (HPV)-Related Oropharyngeal Squamous Cell Carcinoma

“…HPV(+) OPSCC tumors often exhibit increased in ltration of cytotoxic T lymphocytes (CTLs) and higher levels of immune checkpoint proteins, such as PD-L1 [24]. This immuneactive TME has paved the way for the successful use of immune checkpoint inhibitors (ICIs) in the treatment of HPV(+) HNSCC [25,26,27]. Unfortunately, only 15-20% of patients with HNSCC bene t from ICI, and this poor outcome is increasingly ascribed to the peculiar characteristics of the TIME [28].…”

The immune microenvironment of HPV-positive and HPV-negative oropharyngeal squamous cell carcinoma: a multiparametric quantitative and spatial analysis unveils a rationale to target treatment-naïve tumors with immune checkpoint inhibitors

“…PD-1 inhibitors pembrolizumab and nivolumab are approved by the Food and Drug Administration for treatment of recurrent or metastatic HNSCC in the first-and second-line settings [16,28,29]. Moreover, ICI therapies are currently being tested in earlier treatment situations, including neoadjuvant setting [30][31][32]. Unfortunately, only 15-20% of patients with HNSCC benefit from ICI, with this poor outcome being increasingly ascribed to peculiar characteristics of the TIME [33].…”