| Autor: |
Cabezas-Camarero S; Medical Oncology Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain., García-Barberán V; Molecular Oncology Laboratory, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain., Benítez-Fuentes JD; Medical Oncology Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain., Sotelo MJ; Medical Oncology Department, Aliada Cancer Center, Lima 15036, Peru.; Medical Oncology Department, Clínica San Felipe, Lima 15072, Peru.; Medical Oncology Department, Hospital María Auxiliadora, Lima 15801, Peru., Plaza JC; Pathology Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain., Encinas-Bascones A; Maxillofacial Surgery Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain., De-la-Sen Ó; Maxillofacial Surgery Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain., Falahat F; Maxillofacial Surgery Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain., Gimeno-Hernández J; Otolaryngology-Head and Neck Surgery Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain., Gómez-Serrano M; Otolaryngology-Head and Neck Surgery Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain., Puebla-Díaz F; Radiation Oncology Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain., De-Pedro-Marina M; Maxillofacial Surgery Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain., Iglesias-Moreno M; Maxillofacial Surgery Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain., Pérez-Segura P; Medical Oncology Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain. |
| Abstrakt: |
Neuroendocrine carcinomas (NECs) of the head and neck (HN) account for <1% of HN cancers (HNCs), with a 5-year overall survival (OS) <20%. This is a retrospective study of HN NECs diagnosed at our institution between 2005 and 2022. Immunohistochemistry and next-generation sequencing (NGS) were used to evaluate neuroendocrine markers, tumor mutational burden (TMB), mutational profiles and T-cell receptor repertoires. Eleven patients with high-grade HN NECs were identified (male:female ratio 6:5; median age 61 (Min-Max: 31-86)): nasoethmoidal (3), parotid gland (3), submaxillary gland (1), larynx (3) and base of tongue (1). Among n = 8 stage II/IVA/B, all received (chemo)radiotherapy with/without prior surgery or induction chemotherapy, with complete response in 7/8 (87.5%). Among n = 6 recurrent/metastatic patients, three received anti-PD1 (nivolumab (2), pembrolizumab (1)): two achieved partial responses lasting 24 and 10 months. After a median follow-up of 30 and 23.5 months since diagnosis and since recurrent/metastatic, median OS was not reached. Median TMB ( n = 7) was 6.72 Mut/Mb. The most common pathogenic variants were TP53, HNF1A, SMARCB1, CDKN2A, PIK3CA, RB1 and MYC. There were 224 median TCR clones ( n = 5 pts). In one patient, TCR clones increased from 59 to 1446 after nivolumab. HN NECs may achieve long-lasting survival with multimodality treatment. They harbor moderate-high TMBs and large TCR repertoires, which may explain responses to anti-PD1 agents in two patients and justify the study of immunotherapy in this disease. |
