Unexpected response with palliative conventional therapy in head and neck squamous cell carcinoma after anti‐programmed death‐1 progression

Abstract

Background The application of anti‐programmed death‐1 (PD‐1) therapies for recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) has found promising results. It is the first “second‐line therapy” in this setting to impact on prognosis. The studies demonstrated overall response rates in the range of 20%. Therefore, HNSCC showed 60%‐80% progression at first evaluation with better overall survival, suggesting regained efficacy of treatments given thereafter. Methods We report three clinical cases treated with anti‐PD‐1 after platinum‐based chemotherapy. Results Our case reports achieved an unforeseen response to conventional therapies supporting the hypothesis of restored responses to conventional therapies after immunotherapy. Conclusions We believe that the inhibition of the PD‐1/PD‐ligand 1 checkpoint may synergize with both chemotherapy or radiotherapy through immunologic interplay, reversing the HNSCC‐induced immune suppression.

Knowing the tumour microenvironment to optimise immunotherapy

“…If this observation is extended to other tumours, it will pave the way to beneficial treatment with chemotherapy after prior immunotherapy. Actually, reports showing unexpected responses to single agent chemotherapy after immunotherapy already exist, at least, in lung cancer 4445 and in head and neck cancer 46 and a similar observation was also reported at the 2018 ASCO meeting 47 .…”

Impact of previous nivolumab treatment on the response to taxanes in patients with recurrent/metastatic head and neck squamous cell carcinoma

“…Dans le cancer du poumon non à petites cellules sans drivers oncogéniques ciblables, les taux de réponses au monochimiothérapies de rattrapage (dont 50% de docétaxel) s'élèvent à 39% ce qui est supérieur aux données de l'ère pré immunothérapie (de l'ordre de 8%) 56 L'étude spécifique des taxanes après anti PD1 n'a pas été réalisée et depuis l'utilisation du nivolumab en deuxième ligne, plusieurs cas de réponses complètes ou partielles majeures aux taxanes en monothérapie sont décrits chez des patients atteints de CEVADS R/M [67][68][69] . Ainsi, nous avons voulu étudier l'effet du nivolumab sur les taxanes en monothérapies sur une plus large cohorte.…”

Re-irradiation for oligoprogression under Nivolumab in recurrent head and neck squamous cell carcinoma: A case report

“…Very limited data focus on R/M HNSCC. In these few reports [16][17][18][19][20], excellent clinical responses were observed with no major side effects (Supplementary Table 1). Our case report adds to this very limited series: the addition of state of the art re-irradiation to Nivolumab allowed to tackle the only macroscopic site of disease progression, defer the need of a further line of treatment and provide sustained clinical benefit.…”