Initial Experience With Palliative “QUAD-SHOT” Radiotherapy With Concurrent And Adjuvant PD-1 Inhibitor For Recurrent And/Or Metastatic Head And Neck Cancer

Basree, Mustafa; Mitchell, Darrion; Dibs, Khaled; Jhawar, Sachin R.; Baliga, Sujith; Bonomi, Maria; Blakaj, Dukagjin; Gamez, M.E.

doi:10.1016/j.ijrobp.2020.07.347

Cited by 3 publications

(3 citation statements)

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“…Neoadjuvant QUAD shot radiation has also been observed to downstage cancer of the oral cavity prior to definitive surgery in case series ( 32 ). While one study documented safety and response to QUAD shot with the addition of paclitaxel, a chemotherapy with radio-sensitizing properties ( 33 ), data on combination therapy is limited ( 34 , 35 ). In this case, the tumor presented with bleeding, which supported the use of radiation to help obtain a better clinical result.…”

Section: Discussionmentioning

confidence: 99%

Case report: The power of immunotherapy in advanced cutaneous squamous cell carcinoma

et al. 2023

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We describe the case of a neglected cutaneous squamous cell carcinoma with extensive facial involvement. The patient is a male in his late 70s who presented to dermatology with a large destructive facial mass that had increased in size gradually over 3 years and then rapidly proliferated, consuming a large portion of his left maxillofacial region. While the immediate reaction was referral to hospice care, medical oncology recommended treatment with cemiplimab, an immune checkpoint inhibitor. Collaboration with multiple providers facilitated the delivery of a multidisciplinary approach utilizing immunotherapy with QUAD shot radiotherapy. The immunotherapy treatment resulted in a dramatic disease regression, but the large facial anatomical defect caused by the carcinoma remained. The patient is undergoing reconstructive surgeries. This case illustrates the potential for significant response with immune checkpoint inhibitors delivered in combination with cyclical hypofractionated radiation therapy for patients with cutaneous squamous cell carcinoma, even in very advanced disease.

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Section: Discussionmentioning

confidence: 99%

Case report: The power of immunotherapy in advanced cutaneous squamous cell carcinoma

et al. 2023

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“…A retrospective analysis of 15 patients with recurrent and/or metastatic head and neck squamous cell carcinoma showed the QS regimen with concurrent and adjuvant ICI resulted in an ORR of 60% and PFS and median OS of 6.5 months and 7.1 months, with only 20% G3 mucositis or dermatitis. 35 The immunomodulatory benefits of RT with ICI demonstrated by pre-clinical studies and clinical evidence of abscopal effect led to the initiation of a multitude of clinical trials and studies, 40 however the optimal strategy to combine RT with immunotherapy remains elusive with inconsistent results. 41 The challenges in successfully translating in vitro findings to effective in vivo therapeutic strategies are influenced by multiple factors such as the unique interplay of immune cells in the tumor microenvironment (TME) in vivo, differences in tumor pathology, variability in RT dose/fractionation, RT dose rate, tumor volume, sequencing and the type of immunotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…However this multimodal treatment is novel and currently there is little published experience with this regimen in the medical literature to document its efficacy and tolerability, although initial clinical experience in advanced head and neck squamous cell carcinoma is promising. 35…”

Section: Introductionmentioning

confidence: 99%

QUAD SHOT Radiotherapy and Doublet Immunotherapy in the Management of Anal Mucosal Melanoma: A Case Series of Efficacy and Toxicity of a Novel Treatment Approach and a Review of the Literature

Higgins

Alipour

Pope

et al. 2022

Clinical Colorectal Cancer

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Patient-Reported Outcomes Assessing the Impact of Palliative Radiotherapy on Quality of Life and Symptom Burden in Head and Neck Cancer Patients: A Systematic Review

et al. 2021

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Incurable head and neck cancer has a poor prognosis and impairs a patient’s health-related quality of life. Palliative radiotherapy may improve or stabilize health-related quality of life and symptoms, best measured by patient-reported outcomes. There is no systematic analysis if palliative radiotherapy for head and neck cancer improves or stabilizes health-related quality of life or symptoms as validly measured by patient-reported outcomes. Therefore, the primary objective of this systematic review (PROSPERO-ID: CRD42020166434) was to assess the effect of palliative radiotherapy for head and neck cancer on patient-reported outcomes. The secondary objective was to assess the rate and quality of use of patient-reported outcomes in relevant studies claiming a “palliative effect” of radiotherapy. The databases MEDLINE/PubMed, EMBASE, Cochrane CENTRAL, “ClinicalTrials.gov” were searched. Concerning the primary objective, four studies were eligible to assess the effectiveness of palliative radiotherapy as measured by patient-reported outcomes. A narrative synthesis suggests a favorable impact of palliative radiotherapy on health-related quality of life and symptom burden. The risk of bias, however, is considerable and the overall quality of evidence low. Concerning the secondary objective, over 90% of studies claiming a “palliative effect” of palliative radiotherapy did either not use patient-reported outcomes or did so by limited quality. In conclusion, implementation of patient-reported outcomes in studies assessing palliative radiotherapy for head and neck cancer should be fostered. Palliative radiotherapy remains an option for head and neck cancer patients, although more studies focusing on patient-reported outcomes are needed.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42020166434

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Initial Experience With Palliative “QUAD-SHOT” Radiotherapy With Concurrent And Adjuvant PD-1 Inhibitor For Recurrent And/Or Metastatic Head And Neck Cancer

Cited by 3 publications

References 0 publications

Case report: The power of immunotherapy in advanced cutaneous squamous cell carcinoma

Case report: The power of immunotherapy in advanced cutaneous squamous cell carcinoma

QUAD SHOT Radiotherapy and Doublet Immunotherapy in the Management of Anal Mucosal Melanoma: A Case Series of Efficacy and Toxicity of a Novel Treatment Approach and a Review of the Literature

Patient-Reported Outcomes Assessing the Impact of Palliative Radiotherapy on Quality of Life and Symptom Burden in Head and Neck Cancer Patients: A Systematic Review

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