Nivolumab for recurrent/metastatic hypopharyngeal squamous cell carcinoma in a liver transplant recipient
| Autor: | Atsuo Takeda, Takahito Kondo, Hiroshi Hirano, Yasuo Ogawa, Akira Okimura, Yusuke Aihara, Kiyoaki Tsukahara, Munehide Nakatsugawa, Naiue Kikawada, Shigeyuki Kawachi |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Urology Cyclosporins B7-H1 Antigen Metastasis 03 medical and health sciences 0302 clinical medicine medicine Living Donors Humans 030223 otorhinolaryngology Hypopharyngeal Neoplasms business.industry Squamous Cell Carcinoma of Head and Neck Head and neck cancer Neck dissection Hypopharyngeal cancer General Medicine Middle Aged medicine.disease Liver Transplantation Radiation therapy Transplantation Nivolumab Otorhinolaryngology Head and Neck Neoplasms 030220 oncology & carcinogenesis Surgery business Progressive disease |
| Zdroj: | Auris, nasus, larynx. 49(4) |
| ISSN: | 1879-1476 |
| Popis: | Nivolumab administration to patients with organ transplantation history requires careful management. Herein, we report the case of a living-donor liver-transplant recipient, a 52-year-old man, with recurrent and metastatic hypopharyngeal cancer treated with nivolumab. He was diagnosed with T2N2bM0 stage IVA hypopharyngeal squamous cell carcinoma. While using oral immunosuppressants (cyclosporine and mycophenolate mofetil), the patient underwent right neck dissection followed by radiotherapy as an initial treatment. Three months after radiotherapy, positron emission tomography scans revealed multiple bone metastases. We administered two courses of the EXTREME regimen, comprising cisplatin, 5-fluorouracil, and cetuximab, as the first-line treatment for distal metastasis, but the patient presented with progressive disease. The patient was administered nivolumab as the second-line treatment. The programmed death-ligand 1 (PD-L1) expression level in a biopsy specimen of the primary hypopharyngeal tumor and resected specimen of the cervical lymph node metastasis was 40% and 10%, respectively. PD-L1 expression was not detected in hepatocytes of the liver biopsy sample obtained before nivolumab introduction. The patient received four courses of nivolumab 240 mg. Although liver dysfunction was alleviated by adjusting the dose of the hepatoprotective agent and cyclosporine, the progressive disease status persisted after completing nivolumab courses. The patient died of hypopharyngeal cancer progression. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect