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Potential efficacy of local therapy for progressive lesions after nivolumab in patients with recurrent or metastatic squamous cell carcinoma of the head and neck

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Abstract

Background

In recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN), local therapy (LT) such as surgery or radiotherapy can be treatment options for improved survival or quality of life. To date, however, few reports have addressed the efficacy of LT for sites of disease progression after immune checkpoint inhibitors, including other cancers.

Methods

We conducted a retrospective analysis of patients with R/M SCCHN originating from the oral cavity, oropharynx, hypopharynx, and larynx and treated with nivolumab. We extracted patients undergoing salvage LT or palliative radiotherapy (RT) to the selected progressive lesion at any time after initiation of nivolumab.

Results

Twenty-four patients received LT. Salvage LT was performed in 9 (37.5%) patients, including surgery and definitive RT in 5 and 4 patients, respectively. Palliative RT was performed in 15 (62.5%) patients. LT was provided in 10 (41.7%) patients for oligoprogressive disease. Twelve (50.0%) patients received subsequent systemic therapy immediately after LT. Classification based on patient treatment divided the population into four subgroups with different prognoses (salvage LT followed by subsequent systemic therapy [n = 3], salvage LT alone [n = 6], palliative RT followed by subsequent systemic therapy [n = 9], and palliative RT alone [n = 6]). Median OS in this order was 24.5, 9.0, 7.3, and 2.4 months (p = 0.001). All patients in the salvage LT followed by subsequent systemic therapy group continued nivolumab.

Conclusion

In R/M SCCHN patients who have received nivolumab, salvage LT for the selected progressive lesion with continuation of nivolumab potentially provides an excellent survival prognosis.

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Authors and Affiliations

  1. Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa-shi, Chiba, 277-8577, Japan

    Masanobu Sato, Tomohiro Enokida, Akihisa Wada, Susumu Okano, Hideki Tanaka, Takao Fujisawa, Yuri Ueda, Naohiro Takeshita, Nobukazu Tanaka & Makoto Tahara

  2. Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Kashiwa, Japan

    Atsushi Motegi, Sadamoto Zenda & Tetsuo Akimoto

  3. Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan

    Masanobu Sato, Takeshi Shinozaki, Kazuto Matsuura & Ryuichi Hayashi

  4. Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Masanobu Sato

  5. Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Akihisa Wada

  6. Department of Otorhinolaryngology-Head and Neck Surgery, Tokyo Medical University, Shinjuku, Tokyo, Japan

    Yuri Ueda

Authors
  1. Masanobu Sato
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  2. Tomohiro Enokida
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Corresponding author

Correspondence to Makoto Tahara.

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Conflict of interest

Author M.T reports grants and personal fees from Ono Pharmaceutical and Bayer, personal fees from Merck Biopharma, MSD, BMS, personal fees from Pfizer, Rakuten Medical, Lilly, Boehringer Ingelheim, Eisai, Chugai Pharmaceutical, Daiichi-Sankyo, Janssen Pharmaceutical, Genmab, Astra Zeneca, Abbvie and Astellas. Other authors have no conflict of interest to disclose.

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Sato, M., Enokida, T., Wada, A. et al. Potential efficacy of local therapy for progressive lesions after nivolumab in patients with recurrent or metastatic squamous cell carcinoma of the head and neck. Int J Clin Oncol 28, 1023–1032 (2023). https://doi.org/10.1007/s10147-023-02351-9

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