Resensitization to Nivolumab after Intratumoral Chemotherapy in Recurrent Head and Neck Squamous Cell Cancer: A Report of 2 Cases

The survival of patients with head and neck squamous cancer with locoregional recurrence is short if salvage surgery or radiation cannot be performed. Systemic chemotherapy based on platinum salts and cetuximab produces only partial and transient responses. Immune checkpoint inhibitors (i.e., nivolu...

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Published in:Case reports in oncology 2020-07, Vol.13 (2), p.835-842
Main Authors: Houessinon, Aline, Moreira, Aurélie, Bettoni, Jérèmie, Schoonaker, Marine, Sauzay, Chloé, Galmiche, Antoine, Coutte, Alexandre, Biet, Aurélie, Krzisch, Claude, Chauffert, Bruno
Format: Article
Language:English
Subjects:
abscopal-like effect
Cancer
Case Report
Case reports
Catheters
Chemotherapy
Cytotoxicity
Dissection
Head & neck cancer
head and neck cancer
Immunotherapy
intratumoral chemotherapy
Life Sciences
Lymphatic system
Metabolism
Metastasis
Monoclonal antibodies
nivolumab
Patients
Radiation therapy
Targeted cancer therapy
Tumors
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Summary:The survival of patients with head and neck squamous cancer with locoregional recurrence is short if salvage surgery or radiation cannot be performed. Systemic chemotherapy based on platinum salts and cetuximab produces only partial and transient responses. Immune checkpoint inhibitors (i.e., nivolumab) lead to a low complete response rate of only about 10%, but in some cases the effects can be long-lasting. Intratumoral chemotherapy (ITC) has been proposed for patients with local recurrence of head and neck squamous cell carcinoma with an objective response rate of 27–50%. However, it often leads to peritumoral tissue necrosis, and the duration of local control is limited. Here, we present 2 patients with head and neck squamous cell cancer whose local recurrences were refractory to intravenous chemotherapy and nivolumab. ITC using nonnecrotizing molecules, associated with nivolumab, led to complete stable local and distant response. ITC seems to trigger tumor resensitization to previously ineffective immunotherapy. This combination deserves an evaluation in the framework of a prospective trial.
ISSN:1662-6575
1662-6575
DOI:10.1159/000507986