Clinical outcome in recurrent and/or metastatic head and neck cancer patients after discontinuation of nivolumab monotherapy due to immune-related adverse events

Acta Otolaryngol. 2020 Dec;140(12):1043-1048. doi: 10.1080/00016489.2020.1807601. Epub 2020 Aug 18.

Abstract

Background: Significant immune-related adverse events (irAEs) requiring therapy discontinuation sometimes occur. The influence of discontinuation on disease control after an irAE is unclear.

Objectives: The aim of this study was to investigate whether or not patients continued to show a response or durable disease control even after stopping therapy following an irAE.

Material and methods: The response after nivolumab monotherapy discontinuation was examined for 14 patients in whom therapy was stopped without progression.

Results: The best response was CR in 5 (36%) patients, PR in 8 (57%) patients and SD in 1 (7%) patient. The estimated 1-year overall and progression-free survival rates were 92.9% and 78.6%, respectively. The best response during nivolumab therapy in patients who developed PD was CR in 0 of 5 patients (0%), PR in 3 of 8 patients (38%) and SD in 1 patient (100%). Patients obtaining CR tended to have a lower risk of PD than those with PR or SD.

Conclusions and significance: Patients with CR status may continue to show a response or durable disease control even after stopping therapy due to an irAE.

Keywords: Nivolumab; complete response; head and neck; immune-related adverse event; squamous cell carcinoma.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Immunological / adverse effects*
  • Antineoplastic Agents, Immunological / therapeutic use
  • Disease Progression
  • Female
  • Head and Neck Neoplasms / drug therapy*
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local
  • Nivolumab / adverse effects*
  • Nivolumab / therapeutic use
  • Remission Induction
  • Treatment Outcome

Substances

  • Antineoplastic Agents, Immunological
  • Nivolumab