First-line treatment of locally advanced HNSCC with double checkpoint inhibition and radiotherapy based on CD8+ T cell infiltration.

Introduction In this open-label Phase II study, patients with stage III-IVB received an induction cycle of combined chemo-immunotherapy with cisplatin / docetaxel plus durvalumab / tremelimumab. The number of CD8 cells in tumor and peritumoral tissue was determined on biopsies before and after chemo-induction therapy. With an increase in CD8 cells, immunotherapy was continued with radiation.

Results In the first 8 out of 10 patients biopsy after induction therapy did not reveal any vital tumor cells, so by definition a complete pathological remission was present. The other patients had a marked increase in CD8 cells to 227 CD8 + cells / mm² to 1074 CD8 + cells / mm². According to the RECIST 1.1 criteria, six patients had a partial response, three a stable disease while one patient was not evaluable after induction therapy. Toxicities grade III & IV occurred in the form of hepatitis and diarrhea in one patient. Peripheral blood showed an increase of the marker CD69 on CD8 + - cytotoxic T-cells associated with an increased expression of PD-1 on T-helper cells.

Conclusion Induction chemotherapy with cisplatin / docetaxel and durvalumab / tremelimumab in non-selected patients with advanced head and neck carcinomas allowed for promising clinical response associated with an immune response in tumor tissue as well as in peripheral blood.

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Publication History

Article published online:
10 June 2020