Efficacy and Safety of Nivolumab in Metastatic Head and Neck Cancer in a University Hospital: Faced with Reality

Introduction:

Nivolumab is a human PD-1 immune checkpoint inhibitor antibody approved for the treatment of patients with metastatic squamous cell carcinoma (PEC) in the head and neck (KHB) or with disease progression during or after platinum-based chemotherapy. In the present evaluation, the use of nivolumab in clinical routine should be considered.

Materials and Methods:

Retrospectively, an outcome evaluation of all patients treated with nivolumab since May 2017 was evaluated.

Results:

A total of 18 patients (13♂/5♀) with metastatic (11 pat.) or locally advanced (6 pat.) PEC in the KHB were treated with nivolumab (4 patients oropharyngeal carcinoma, 5 hypopharynx, 5 oral cavities, 1 NNH -, 1 salivary glands, 1 nasopharyngeal, 1 CUP). In the patients who received at least four cycles of nivolumab, the response to therapy was assessed. In three patients, treatment was discontinued because of grade 3 (skin, pituitary) or grade 4 toxicity (liver). Complete remission was seen in 3 patients, some remission in 3 patients, and progression in 12 patients, of whom 7 died. Thus, the response rate and disease control rate of nivolumab was 33% in our patients regardless of the PD-L1 status at initiation of treatment.

Summary:

In the current study, nivolumab was given as currently approved. The survival and efficacy results of the pivotal study were confirmed. We therefore continue to recommend the continued use of nivolumab for the treatment of head and neck cancer in our head and neck tumor center.

Publication History

Publication Date:
23 April 2019 (online)