the most common adverse events were anaemia (26 [70%]), fatigue (25 [68%]), and rash
hypothyroidism
hypothyroidism
nivolumab-related autoimmune hypothyroidism, which resolved after a short course of corticosteroids
No grade 3 or 4 adverse events occurred
Nivolumab resulted in objective responses in 24% of patients with metastatic SCCA
Historically, doublet chemotherapy with cisplatin and fluorouracil has been the most common treatment for patients with metastatic SCCA
our results suggest that immune checkpoint blockade agents might extend overall survival beyond currently available therapies, especially if provided early in the disease treatment course
the dose of nivolumab we used differs from the 2016 recommendation of a fixed 240 mg every 2 weeks
25% of patients develop distant metastases
most patients with localised SCCA are cured by chemoradiation
More than 90% of cases of SCCA are linked to prior infection with human papillomavirus (HPV)
Within tumour cells, HPV oncoproteins are immunogenic and can trigger an anti-tumour host immune response by recruitment of tumour-infiltrating lymphocytes
Tumour cells express PD-L1 and, on binding its inhibitory receptor PD-1 on the surface of T cells, downregulate T-cell activation and thwart the local anti-tumour immune response
Nivolumab is a humanised monoclonal antibody against PD-1 that disrupts this interaction, enabling T-cell cytotoxicity. It has activity as a monotherapy in advanced solid cancers, such as head and neck cancer, melanoma, non-small-cell lung cancer, and renal cell carcinoma