In regard to Cabezas-Camarero et al.

Response to Yilmaz et al.

“…High radiotherapy doses over regional lymph nodes combined with the ‘lag’ time that anti-PD(L)1 agents need to ‘unleash’ the breaks of T cells may explain the negative results of ‘concurrent’ radiotherapy + IO trials [11–13]. Third, the radiation modality used in our patient was hypofractionated palliative radiotherapy with 25 Gy in 5 fractions, which is a lower biological dose than the 8 Gy per fraction used by Yilmaz and coauthors in their patients [1,2]. The local control rate and survival results with SBRT and concurrent anti-PD1 agents in their patients are remarkable.…”

“…The authors claim priority over our case report, arguing for the previous publication of two studies where they used concurrent anti-PD1 therapy and stereotactic body radiotherapy (SBRT) in a heterogeneous series of head and neck cancers (HNC) from diverse sites, including sinonasal and nasopharyngeal cancers, among other more common subsites. However, they used an approach that differs in three fundamental aspects from that employed in our patient [1–3]. First, they used concurrent radiotherapy combined with anti-PD1 therapy, while in our patient IO (nivolumab) was administered before and after radiotherapy, but not ‘concurrently’ with radiotherapy.…”