2022 Volume 115 Issue 10 Pages 875-881
Introduction
The overall survival rate (OS) of head and neck carcinoma patients with resistance or intolerance to platinum agents had improved significantly with the introduction of immune checkpoint inhibitors (anti PD-1 antibody). At the same time, the proportion of patients developing immune-related adverse events (irAEs) and requiring sequential treatment is not negligible.
Subject and methods
The present study population included 42 patients, all of whom were treated with nivolumab at our institution from April 2017 to December 2019. We conducted a retrospective review of the patient data, to determine the OS, progression-free survival rate (PFS), overall response rate (ORR), and disease control rate (DCR) in the patients using the Kaplan-Meier method. Furthermore, we also determined the incidence/severity of irAE in accordance with the Common Terminology Criteria for Adverse Events Version (CTCAE) 4.0.
Results
The median of OS was 336 days, the 1-year OS was 49.9%, and the 2-year survival rate was 24.4%. The median PFS was 111 days, and the 1-year PFS was 17.1%. However, subgroup analysis of the patients classified by the histopathological category into the SCC group and non-SCC group revealed that while the median OS period and 1-year OS were 17.9 months and 53.2%, respectively, in the 30 cases of SCC, and 10.4 months and 41.7%, respectively, in the 12 cases of non-SCC group. There was 1 case of complete response, 5 cases of partial response, 13 cases of stable disease, and 21 cases of progressive disease. On the other hand, the ORR was 15%, and the DCR was 47.5%. Moreover, the appearance of irAE necessitated discontinuation of nivolumab in 8 cases.
Conclusion
① Although the efficacy of nivolumab was not significantly different from that reported by other authors, there was a tendency for a relative high proportion of patients to require treatment discontinuation because of the occurrence of irAE.
② There was one case of long survival as a result of prompt management of the irAE and continuation of nivolumab treatment.
