2019 Volume 22 Issue 2 Pages 79-85
Nivolumab, an anti-programmed cell death-1 monoclonal antibody, is currently used for patients with a range of advanced cancers, including recurrent and metastatic head and neck cancer. The drug was first introduced at our department in April 2017 and had been used for 20 patients by October 2018. In this report, we describe 4 patients with recurrent/metastatic head and neck cancer who were markedly responsive to nivolumab. The first patient was a 71-year-old woman who presented with lung metastasis after treatment for laryngeal cancer. After 4 months of nivolumab treatment, the tumor of the lung markedly decreased in size and the response was maintained for 10 months despite patient-requested drug withdrawal at the 6th month. The second patient was a 71-year-old man who presented with recurrent nasopharyngeal cancer and lung metastasis, which were refractory to CyberKnife® radiosurgery and chemotherapy. After 3 months of nivolumab treatment, both the primary tumor that extended to the skull base and metastatic lung tumor markedly decreased in size, and the response was maintained for 10 months despite drug withdrawal at the 6th month. The third patient was a 68-year-old man with relapsed oropharyngeal cancer. Although the tumor responded to nivolumab, he developed candidemia, resulting in drug withdrawal and regrowth of the tumor. However, the tumor again decreased in size in response to cetuximab, which was substituted for nivolumab. The last patient was a 73-year-old man who presented with recurrent laryngeal cancer 12 years after initial treatment. The tumor markedly decreased in size two months after nivolumab treatment, but he developed isolated adrenocorticotropic hormone deficiency. Although nivolumab was withdrawn, the response was maintained for 8 months. All 4 patients presented here were markedly responsive to nivolumab, leading to favorable clinical courses.
