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International Journal of Clinical Oncology

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21-06-2023 | Radiotherapy | Original Article

Potential efficacy of local therapy for progressive lesions after nivolumab in patients with recurrent or metastatic squamous cell carcinoma of the head and neck

Authors: Masanobu Sato, Tomohiro Enokida, Akihisa Wada, Susumu Okano, Hideki Tanaka, Takao Fujisawa, Yuri Ueda, Atsushi Motegi, Takeshi Shinozaki, Naohiro Takeshita, Nobukazu Tanaka, Sadamoto Zenda, Kazuto Matsuura, Tetsuo Akimoto, Ryuichi Hayashi, Makoto Tahara

Published in: International Journal of Clinical Oncology | Issue 8/2023

Abstract

Background

In recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN), local therapy (LT) such as surgery or radiotherapy can be treatment options for improved survival or quality of life. To date, however, few reports have addressed the efficacy of LT for sites of disease progression after immune checkpoint inhibitors, including other cancers.

Methods

We conducted a retrospective analysis of patients with R/M SCCHN originating from the oral cavity, oropharynx, hypopharynx, and larynx and treated with nivolumab. We extracted patients undergoing salvage LT or palliative radiotherapy (RT) to the selected progressive lesion at any time after initiation of nivolumab.

Results

Twenty-four patients received LT. Salvage LT was performed in 9 (37.5%) patients, including surgery and definitive RT in 5 and 4 patients, respectively. Palliative RT was performed in 15 (62.5%) patients. LT was provided in 10 (41.7%) patients for oligoprogressive disease. Twelve (50.0%) patients received subsequent systemic therapy immediately after LT. Classification based on patient treatment divided the population into four subgroups with different prognoses (salvage LT followed by subsequent systemic therapy [n = 3], salvage LT alone [n = 6], palliative RT followed by subsequent systemic therapy [n = 9], and palliative RT alone [n = 6]). Median OS in this order was 24.5, 9.0, 7.3, and 2.4 months (p = 0.001). All patients in the salvage LT followed by subsequent systemic therapy group continued nivolumab.

Conclusion

In R/M SCCHN patients who have received nivolumab, salvage LT for the selected progressive lesion with continuation of nivolumab potentially provides an excellent survival prognosis.

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Title: Potential efficacy of local therapy for progressive lesions after nivolumab in patients with recurrent or metastatic squamous cell carcinoma of the head and neck
Authors: Masanobu Sato
Tomohiro Enokida
Akihisa Wada
Susumu Okano
Hideki Tanaka
Takao Fujisawa
Yuri Ueda
Atsushi Motegi
Takeshi Shinozaki
Naohiro Takeshita
Nobukazu Tanaka
Sadamoto Zenda
Kazuto Matsuura
Tetsuo Akimoto
Ryuichi Hayashi
Makoto Tahara
Publication date: 21-06-2023
Publisher: Springer Nature Singapore
Keywords: Radiotherapy
Systemic Therapy
Checkpoint Inhibitors
Published in: International Journal of Clinical Oncology / Issue 8/2023
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-023-02351-9

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Abstract

Background

Methods

Results

Conclusion

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