دورية أكاديمية
Complete Response to Nivolumab in Recurrent/Metastatic HPV-Positive Head and Neck Squamous Cell Carcinoma Patient After Progressive Multifocal Leukoencephalopathy: A Case Report
العنوان: | Complete Response to Nivolumab in Recurrent/Metastatic HPV-Positive Head and Neck Squamous Cell Carcinoma Patient After Progressive Multifocal Leukoencephalopathy: A Case Report |
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المؤلفون: | Locati L. D., Serafini M. S., Carenzo A., Canevari S., Perrone F., Orlandi E., Delbue S., Cavalieri S., Berzeri G., Pichiecchio A., Licitra L. F., Marchioni E., De Cecco L. |
المساهمون: | L.D. Locati, M.S. Serafini, A. Carenzo, S. Canevari, F. Perrone, E. Orlandi, S. Delbue, S. Cavalieri, G. Berzeri, A. Pichiecchio, L.F. Licitra, E. Marchioni, L. De Cecco |
بيانات النشر: | Frontiers Media |
سنة النشر: | 2022 |
المجموعة: | The University of Milan: Archivio Istituzionale della Ricerca (AIR) |
مصطلحات موضوعية: | case report, HNSCC, HPV, immunotherapy, oropharynx, PML, Settore MED/07 - Microbiologia e Microbiologia Clinica |
الوصف: | In an immune-competent context nivolumab showed long-term benefit in overall survival in recurrent/metastatic head and neck squamous cell carcinoma (HNSCC); however, in special cancer population such as these patients with immunodeficiency and viral infections, data on checkpoint inhibitors (ICI) activity are scant. Herein, we report a patient with a Human papilloma virus (HPV)-related oropharyngeal cancer (OPC) and CD4 lymphocytopenia. After a first-line treatment complete remission, the patient experienced Human Polyomavirus (JCV) infection in the brain. Consequently, to the recovery from progressive multifocal leukoencephalopathy (PML) the patient metastasized and was enrolled in a single-arm trial with nivolumab (EudraCT number: 2017-000562-30). A complete and durable response (more 3 years) was observed after 10 nivolumab injections Q2wks, interrupted for persistent drug related G2 diarrhea and a syndrome of inappropriate antidiuretic hormone secretion. We describe the circulating immune profile (before-, during-, and after nivolumab), consistent with the clinical history. Moreover, during nivolumab treatment, brain MRI evidenced the presence of small punctuate areas of contrast enhancement, reflecting a mild immune response in perivascular spaces. By cytofluorimetry, we observed that during JCV infection the CD4/CD8 ratio of the patient was under the normal values. After JCV infection recovery and before nivolumab treatment, CD4/CD8 ratio reached the normality threshold, even if the CD4+ T cell count remained largely under the normal values. During ICI, gene expression xCell analyses of circulating immune cells of the patient, showed a progressive normalization of the total immune profile, with significant boost in CD4+ and CD8+ T cells and a reduction in NK T, comparable to the circulating immune profile of reference tumor-free HNSCC patients. The present case supports the activity of ICI in a population of special cancer patients; whether JCV and HPV infections (alone or together) might have a possible ... |
نوع الوثيقة: | article in journal/newspaper |
اللغة: | English |
العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/35083153; info:eu-repo/semantics/altIdentifier/wos/WOS:000748089100001; volume:11; firstpage:1; lastpage:11; numberofpages:11; journal:FRONTIERS IN ONCOLOGY; http://hdl.handle.net/2434/903187Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85123363195 |
DOI: | 10.3389/fonc.2021.799453 |
الإتاحة: | https://doi.org/10.3389/fonc.2021.799453Test http://hdl.handle.net/2434/903187Test |
حقوق: | info:eu-repo/semantics/openAccess |
رقم الانضمام: | edsbas.77772EC6 |
قاعدة البيانات: | BASE |
DOI: | 10.3389/fonc.2021.799453 |
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