Re-irradiation for oligoprogression under Nivolumab in recurrent head and neck squamous cell carcinoma: A case report. (July 2020)

• Record Type: Journal Article
• Authors: Bonomo, Pierluigi; Lucidi, Sara; Desideri, Isacco; Scotti, Vieri; Casati, Marta; Palomba, Annarita; Ciabatti, Cinzia; Garlatti, Pietro; Massi, Daniela; Gallo, Oreste; Livi, Lorenzo
• Is Part Of: Clinical and translational radiation oncology. Volume 23(2020)
• Page Start: 16
• Page End: 19
• Publication Date: 2020-07
• Subjects: Head and neck cancer -- Immunotherapy -- Re-irradiation -- Oligoprogression -- Intensity modulated radiotherapy -- Nivolumab; Cancer -- Radiotherapy -- Periodicals; Oncology -- Periodicals; Cancer -- Radiotherapy; Oncology; Radiation Oncology; Neoplasms -- radiotherapy; Translational Medical Research; Periodicals; Electronic journals; Periodicals; 616.9940642
• DOI: 10.1016/j.ctro.2020.04.007
• Languages: English
• ISSNs: 2405-6308

Abstract

Highlights: Immunotherapy is a new option for head and neck squamous cell carcinoma. Very limited data are available for concurrent radio-immunotherapy in recurrent disease. Our case report adds to this very limited series, focusing on oligopression under immunotherapy. Abstract: Immune checkpoint inhibitors (ICIs) represent a recently introduced class of agents active in head and neck squamous cell carcinoma (HNSCC). For a subgroup of patients with recurrent or metastatic disease, long-term benefit can be achieved: maintaining a sustained response to immunotherapy is therefore a critical factor for its efficacy at an individual level. In analogy to targeted agents, a limited pattern of progression, or "oligoprogression", can occur. For locally recurrent HNSCC, the potential biologic interplay between the efficacy of ICIs and the design of radiation fields chosen for primary treatment is currently unknown. Here, we report on a patient who presented two subsequent oligoprogressions successfully treated with re-irradiation without interrupting Nivolumab. Both oligoprogressive lesions developed in previously unirradiated areas. We hypothesize the existence of a synergistic effect with optimal spatial cooperation between ICIs and re-irradiation for oligoprogressive disease under immunotherapy.