Imunoterapija pri ploščatoceličnem karcinomu glave in vratu

Background: Immunotherapy with immune checkpoints inhibitor nivolumab – inhibitory antibody against programmed death receptor-1 (anti-PD-1) – represents an important new treatment option for patients with incurable recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) unresponsive to platinum-based chemotherapy. It significantly prolongs survival compared to standard chemotherapy.Methods: A retrospective analysis of treatment with nivolumab in patients with R/M HNSCC in Slovenia who received their first dose of nivolumab until March 2020 was performed. Data collection was completed in September 2020. Descriptive statistics and log-rank test were used.Results: Twenty-seven patients entered the study. Median time of follow-up from the first nivolumab application onward was 7.4 months, and relative 6-month overall survival was 59% (95% confidence interval 41–78%). In 85% of patients, the response to treatment was evaluated using clinical examination and chest x-ray only. In 41% of patients the partial response to treatment was declared as the best response achieved. Thirty percent of patients experienced immune related adverse events of which all were grade ≤2. In one patient radiotherapy was delivered concurrently with nivolumab.Conclusion: According to the presented results, treatment with nivolumab has also been shown to be safe in Slovenian patients with R/M HNSCC. Due to the short follow-up time, the observed efficacy cannot be compared with the results of foreign studies. With the expected approval of pembrolizumab, the immune checkpoint inhibitors will also be given a place in the first line treatment of R/M HNSCC in Slovenia.