The impact of locoregional treatment on response to nivolumab in advanced platinum refractory head and neck cancer: The need trial

Andrea Botticelli, Silvia Mezi, Giulia Pomati, Paolo Sciattella, Bruna Cerbelli, Michela Roberto, Giulia Mammone, Alessio Cirillo, Alessandra Cassano, Carmela Di Dio, Alessio Cortellini, Laura Pizzuti, Graziana Ronzino, Massimiliano Salati, Patrizia Vici, Antonella Polimeni, Marco Carlo Merlano, Marianna Nuti, Paolo Marchetti

Research output: Contribution to journalArticlepeer-review


Background: Previous locoregional treatment could affect the response to nivolumab in platinum-refractory recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). The aim of this study is to evaluate the impact of the clinicopathological characteristics and previous treatment in predicting early progression to nivolumab in a real-world population. Methods: This is an observational, multicenter retrospective/prospective study including patients (pts) with platinum refractory R/M HNSCC who received nivolumab 240 mg every 2 weeks from October 2018 to October 2019. We analyzed the association between previous treatment, clinicopathological characteristics, and early progression (within 3 months). Results: Data from 61 pts were reviewed. Median age was 67 years (30–82). Forty-two pts (69%) received previous locoregional treatment. Early progression to nivolumab occurred in 36 pts (59%), while clinical benefit (stable disease and partial response) was achieved in 25 pts (41%). Early progression to nivolumab was significantly associated to previous locoregional treatment both at univariate and multivariate analysis (p = 0.005 and p = 0.048, respectively). Conclusion: nivolumab in R/M HNSCC is burdened with a high early progression rate. Previous wide neck dissection and high dose radiotherapy may compromise the efficacy of nivolumab, distorting the anatomy of the local lymphatic system and hindering the priming of immune response.

Original languageEnglish
Article number191
Issue number2
Publication statusPublished - Jun 2020


  • Head and neck cancer
  • Immunotherapy
  • Locoregional treatment
  • Nivolumab
  • Squamous cell carcinoma

ASJC Scopus subject areas

  • Immunology
  • Pharmacology
  • Drug Discovery
  • Infectious Diseases
  • Pharmacology (medical)


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