Spontaneous regression of laryngeal squamous cell carcinoma

Sipaul, Fabian; Ling, Baoyong; Mason, Caitlin; Keast, Allan

doi:10.1017/s0022215115002595

Cited by 8 publications

(2 citation statements)

References 5 publications

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“…From this point of view, a sensational event such as spontaneous cancer remission, although rare, is scientifically acceptable. This phenomenon was even reported in a patient with laryngeal carcinoma after a period of prolonged pyrexia [46]. Nonetheless, there remain many unanswered questions about how to augment tumour immunogenicity and select potential responders.…”

Section: Introductionmentioning

confidence: 84%

Immunotherapy in head and neck cancer: aiming at EXTREME precision

Szturz

Vermorken

2017

BMC Med

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BackgroundLocoregionally advanced, recurrent, and metastatic squamous cell carcinomas of the head and neck (SCCHN) remain difficult to treat disease entities, in which systemic treatment often forms an integral part of their management. Immunotherapy is based on functional restoration of the host immune system, helping to counteract various tumour evasion strategies. Broadly, immunotherapeutic approaches encompass tumour-specific antibodies, cancer vaccines, cytokines, adoptive T-cell transfer, and immune-modulating agents. Until 2015, the epidermal growth factor receptor inhibitor cetuximab, a tumour-specific antibody, represented the only Food and Drug Administration (FDA)-approved targeted therapy for SCCHN. Subsequently, in 2016, the results from two prospective trials employing the immune-modulating antibodies nivolumab and pembrolizumab heralded a new era of anticancer treatment.DiscussionNivolumab and pembrolizumab are monoclonal antibodies against programmed cell death protein-1 (PD-1), an ‘immune checkpoint’ receptor. Found on the surface of T-cells, PD-1 negatively regulates their activation and can thus be exploited during carcinogenesis. The second-line phase III trial CheckMate-141 randomly assigned 361 patients with recurrent and/or metastatic SCCHN in a 2:1 ratio to receive either single-agent nivolumab (3 mg/kg intravenously every 2 weeks) or standard monotherapy (methotrexate, docetaxel, or cetuximab). Nivolumab improved the objective response rate (13% versus 6%) and median overall survival (OS; 7.5 versus 5.1 months, p = 0.01) without increasing toxicity. Exploratory biomarker analyses indicated that patients treated with nivolumab had longer OS than those given standard therapy, regardless of tumour PD-1 ligand (PD-L1) expression or p16 status. In the non-randomised, multicohort phase Ib study KEYNOTE-012, treatment with pembrolizumab achieved comparable results. Importantly, most of the responding patients had a long-lasting response.ConclusionBased on recent results, nivolumab and pembrolizumab have been approved by the FDA as new standard-of-care options for the second-line treatment of recurrent and/or metastatic SCCHN. Generally well tolerated, these novel drugs demonstrated modest response rates, with tumour regressions usually being durable, even in platinum-resistant/refractory cases. The next step will be to extend the observed benefit to first-line treatment, currently dominated by the EXTREME regimen (platinum/5-fluorouracil/cetuximab), and to the locoregionally advanced setting, where concurrent chemoradiation with cisplatin is standard. Regimens combining immunotherapy with other modalities will probably further improve outcomes.

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Section: Introductionmentioning

confidence: 84%

Immunotherapy in head and neck cancer: aiming at EXTREME precision

Szturz

Vermorken

2017

BMC Med

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“…Some of these hypotheses include immune modulation of the host, activated by local trauma or necrosis/ devascularization via biopsy, locoregional infection, or prolonged pyrexia. 2,4,5 Moreover, possible influential factors contributing to these hypotheses include fever and/or infection, allergic or immune reactions, endocrine influence, unusual sensitivity to routine inadequate therapy, interference with nutrition of the tumor, or removal of carcinogenic agent. 1 A primary hypothesis is that an immunological response can be initiated after trauma to the area, such as biopsy.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Regression of Laryngeal Squamous Cell Carcinoma After Biopsy

et al. 2020

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Approximately 7 cases of spontaneous regression of adult laryngeal carcinoma have been published in the literature since 1900. This case presents a 62-year-old male with a 6-month history of hoarseness who was subsequently diagnosed with a T1aN0M0 left true vocal fold squamous cell carcinoma (SCC) after biopsy. One month following the initial biopsy, histopathological findings on repeat biopsy revealed absence of malignancy and regression of the tumor without radiation. There has been no evidence of tumor recurrence. This case exemplifies how innate immune modulation may play a role in the spontaneous regression of laryngeal SCC, although the mechanism remains unknown.

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