Nivolumab monotherapy after induction chemotherapy, bioradiotherapy, and cetuximab monotherapy leading to complete remission of locoregional advanced tongue cancer: A case report

Abstract

Currently, immunotherapy using immune checkpoint inhibitors including nivolumab, ipilimumab, and pembrolizumab has been the main treatment for patients with recurrent/metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN). Nivolumab is a human monoclonal antibody targeting programmed death (PD)-1. It is approved for patients with platinum-refractory R/M SCCHN according to the results of the CheckMate 141 trial. 1,2 There have been many reports of immunotherapy with nivolumab for R/M SCCHN in Japan since it was approved by the Japanese Authorized Committee in March 2017. 3,4 However, to the best of our knowledge, no case had been reported of locoregional advanced (LA) tongue cancer successfully controlled for more than 5 years using nivolumab monotherapy after induction chemotherapy (IC) with docetaxel (DTX), cisplatin (CDDP), and 5-fluorouracil (5-FU) followed by bioradiotherapy (BRT) and subsequent cetuximab monotherapy. Herein, we present a case of a patient with LA tongue cancer who achieved complete remission using nivolumab monotherapy after a multidisciplinary therapy. | Case reportA 66-year-old woman was referred to our hospital due to swelling of the left side of her neck in September 2015. She had no history of alcohol drinking or cigarette smoking. However, she had a history of hypertension. Both her father and elder sister died of colorectal and thyroid cancer, respectively. On clinical examination, an ulcerated mass extending to the underside of the left side of the tongue from the lateral tongue margin with a large adhesive cervical mass exceeding 100 mm in diameter was observed (Figure 1A,B).Contrast-enhanced computed tomography (CT) showed that this primary tumor occupied almost half of the left side of the tongue and had invaded the extrinsic muscles of the tongue, extending to

Enhanced degradation of epidermal growth factor receptor by metformin

“…Epidermal growth factor receptor (EGFR) is overexpressed or mutated and associated with malignancy in various tumors, including oral squamous cell carcinoma (OSCC). 1,2 Therefore, various antitumor drugs targeting EGFR have been developed. Nevertheless, EGFR remains one of the most promising targets of extensive research to further improve cancer treatment.…”

“…Epidermal growth factor receptor (EGFR) is overexpressed or mutated and associated with malignancy in various tumors, including oral squamous cell carcinoma (OSCC) 1,2 . Therefore, various antitumor drugs targeting EGFR have been developed.…”

Collagen cross‐linking in oral cancer

“…Radiation therapy for patients with clinical T1‐2 oral cancer without nodal metastases is also an essential part of treatment 5–7 . This approach is effective in cases for which the cancer has penetrated the tissue gap and is thus unresectable 8–11 . However, as with immuno‐chemotherapy, some patients also develop resistance to radiation therapy.…”

“…[5][6][7] This approach is effective in cases for which the cancer has penetrated the tissue gap and is thus unresectable. [8][9][10][11] However, as with immunochemotherapy, some patients also develop resistance to radiation therapy. Thus, there is an urgent need to develop effective alternative approaches to treat oral cancer that can minimize these complications.…”