Nivolumab in patients with rare head and neck carcinomas: A single center’s experience

Kokkali, Stefania; Ntokou, Anna; Drizou, Maria; Perdikari, Konstantina; Makaronis, P.; Katsarou, Elena; Koufopoulos, Nektarios; Tzovaras, Alexandros; Ardavanis, Alexandros

doi:10.1016/j.oraloncology.2019.07.002

Cited by 14 publications

(8 citation statements)

References 11 publications

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“…Some published case series have suggested that nivolumab confers a survival benefit on patients with HNC with rare primary sites. 6 However, our study found no significant difference between the survival outcomes of patients with HNC in other primary sites than larynx, oral cavity, and pharynx, which suggests that even patients with rare HNC sites might benefit from nivolumab treatment.…”

Section: Discussioncontrasting

confidence: 66%

<p>Efficacy of Nivolumab for Head and Neck Cancer Patients with Primary Sites and Histological Subtypes Excluded from the CheckMate-141 Trial</p>

Sato

Fukuda

Wang

et al. 2020

CMAR

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Background: In the CheckMate-141 trial, nivolumab conferred a survival benefit in patients with recurrent or metastatic refractory squamous cell carcinoma (SCC) head and neck cancer (HNC). Here, we examined the efficacy of nivolumab in patients with histological subtypes or primary sites of HNC not included in the CheckMate-141 trial. Methods: This was a retrospective analysis of data collected prospectively from 97 patients who were treated with nivolumab for recurrent or metastatic HNC at our institution. The patients were assigned to three groups based on HNC primary site: 1) oral cavity, pharynx, and larynx, which were included in CheckMate-141 (n = 68), 2) nasopharynx (excluded in CheckMate-141, n = 7) and 3) other primary sites excluded in CheckMate-141 (n = 22) and assigned to two groups according to histological subtype: 1) SCC (included in CheckMate-141, n = 83) and 2) non-SCC (all sites excluded in CheckMate-141, n = 14). Survival outcomes and nivolumab treatment response were compared between the primary site and histological subgroups. Results: The median number of nivolumab treatments was 7 cycles (range, 1-53 cycles) and the median follow-up time was 9.1 months (range, 0.66-33.0 months). There were no significant differences in response rates between the three primary site subgroups (CheckMate-141 sites 22%, nasopharynx 43%, others 18%; p=0) or the two histological subtype subgroups (SCC 25%, non-SCC 7%, p=0). Similarly, overall survival and progression-free survival were comparable for patients stratified by primary site or histological subtype. Conclusion: No significant difference in response rates or survival outcomes was detected between nivolumab-treated HNC patients with primary sites and histological subtypes that were included versus excluded in the CheckMate-141 trial. These data provide a potential rationale for nivolumab therapy for all HNC patients in clinical practice.

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Section: Discussioncontrasting

confidence: 66%

<p>Efficacy of Nivolumab for Head and Neck Cancer Patients with Primary Sites and Histological Subtypes Excluded from the CheckMate-141 Trial</p>

Sato

Fukuda

Wang

et al. 2020

CMAR

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“…In contrast, Ross et al analyzed tumor mutation burden (TMB), which is known to be associated with favorable tumor response to ICIs, in 623 cases of SGC, and reported that the TMB of SGC was significantly lower than that of other tumor types for which ICIs were approved such as melanoma and breast cancer, although cases of cystadenocarcinoma were not included in this study (15). Consistently, recent studies demonstrated limited efficacy of anti-PD-1 monotherapy for advanced SGCs (16)(17)(18). However, there were no cases of cystadenocarcinoma within these studies, and there have been no reports of advanced cystadenocarcinoma of the salivary gland treated with ICIs.…”

Section: Discussionmentioning

confidence: 51%

Case Report: Complete Response of Recurrent and Metastatic Cystadenocarcinoma of the Parotid Gland With a Single Course of Combined Nivolumab and Ipilimumab Therapy

et al. 2021

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Although cystadenocarcinoma is classified as a low-grade histological subtype of salivary gland carcinoma (SGC), recurrence and metastases sometimes develop. However, standard treatments for advanced cases have not yet been established. Here, we present a case of unresectable local recurrence and cervical lymph node metastases of cystadenocarcinoma of the parotid gland with multiple lung nodules, all of which showed complete response with only a single course of combined nivolumab and ipilimumab therapy. The patient's medical history of metastatic melanoma roused our suspicions that the multiple lung nodules were cystadenocarcinoma metastases or malignant melanoma. Combination therapy was used based on our suspected diagnosis of lung metastases of melanoma although histological examination of the lung nodules could not be performed. While various chemotherapies are used for advanced SGCs including cystadenocarcinoma, overall, the results are unsatisfactory. In contrast, there have not yet been any reports of advanced cystadenocarcinoma of the salivary gland treated with immune checkpoint inhibitors (ICIs). Given that, in our case, a single course of combined ICI therapy induced a complete response in the unresectable and lymph node metastases from the cystadenocarcinoma and the multiple lung nodules, ICIs, including combined therapy, could be a promising treatment for advanced cystadenocarcinoma.

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“…Regarding the primary tumor site, while we performed nivolumab therapy in patients not included in the CheckMate 141 trial, such as nasopharyngeal cancer, clinical outcomes were comparable to those included in the CheckMate 141 trial 1,7 . In patients excluded from the CheckMate 141 trial, the efficacy of nivolumab therapy has been reported with primary tumors at other sites, including the nasopharynx, while its efficacy is limited in the salivary gland cancer 5,[26][27][28] . However, there is insufficient evidence for the optimal systematic therapy for HNC other than squamous cell carcinoma (SCC).…”

Section: Discussionmentioning

confidence: 99%

Novel Prognostic Score for recurrent or metastatic head and neck cancer patients treated with Nivolumab

Minohara

Matoba

Kawakita

et al. 2021

Sci Rep

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Although several prognostic factors in nivolumab therapy have been reported in recurrent or metastatic head and neck cancer (RM-HNC) patients, these factors remain controversial. Here, we conducted a multicenter retrospective cohort study to investigate the impact of clinico-hematological factors on survival in RM-HNC patients treated with nivolumab. We reviewed 126 RM-HNC patients from seven institutes. We evaluated the prognostic effects of clinico-hematological factors on survival. The median overall survival (OS) was 12.3 months, and the 1 year-OS rate was 51.2%. Patients without immune-related adverse events, lower relative eosinophil count, worse best overall response, higher performance status, and higher modified Glasgow Prognostic Score had worse survival. The score, generated by combining these factors, was associated with survival. Patients with score of 4–5 had worse survival than those with score of 2–3 and 0–1 [adjusted HR for PFS: score of 4–5, 7.77 (3.98–15.15); score of 2–3, 3.44 (1.95–6.06), compared to score of 0–1], [adjusted HR for OS: score of 4–5, 14.66 (4.28–50.22); score of 2–3, 7.63 (2.29–25.37), compared to score of 0–1]. Our novel prognostic score utilizing clinico-hematological factors might be useful to establish an individual treatment strategy in RM-HNC patients treated with nivolumab therapy.

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Nivolumab in patients with rare head and neck carcinomas: A single center’s experience

Cited by 14 publications

References 11 publications

<p>Efficacy of Nivolumab for Head and Neck Cancer Patients with Primary Sites and Histological Subtypes Excluded from the CheckMate-141 Trial</p>

<p>Efficacy of Nivolumab for Head and Neck Cancer Patients with Primary Sites and Histological Subtypes Excluded from the CheckMate-141 Trial</p>

Case Report: Complete Response of Recurrent and Metastatic Cystadenocarcinoma of the Parotid Gland With a Single Course of Combined Nivolumab and Ipilimumab Therapy

Novel Prognostic Score for recurrent or metastatic head and neck cancer patients treated with Nivolumab

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