Successful Use of Nivolumab in a Patient with Head and Neck Cancer After Allogeneic Bone Marrow Transplantation

Figures & data

Figure 1 Head and neck CT images showing tumor before (A) and after treatment with nivolumab (B, C, respectively).

Note: The arrows indicate the maximum length diameter of tumor or tumor site.

Abbreviation: CT, computed tomography.

Table 1 Case Reports of Nivolumab Use After Allo-HSCT

Study	Dose (mg/kg)	Primary Disease (n)	Prior GVHD (Grade)	Interval	Response	GVHD (Grade)	Other Outcomes (n)
Angenendt et al,^Citation31 2016	3	HL (1)	None	1.5 years	CR	None	Mild fever
Yared et al,^Citation32 2016	0.5–3	HL (1)	None	7 months	PR	None	Pneumonitis, hepatitis
Onizuka et al,^Citation33 2017	0.5–2	HL (1)	aGVHD (3)	1.1 years	PR	cGVHD	None
Shad et al,^Citation34 2016	3	HL (3)	None	1.2 years	CR	None	None
Albring et al,^Citation43 2016	**	AML (3)	None/none/none	8 m/NA/5m	CR/SD/PD	aGVHD (2)/none/none	Pancytopenia/myalgias/pancytopenic
Godfrey et al,^Citation35 2017	3	HL (3)	None/cGVHD/cGVHD	¶NA	PR/PR/PR	None	Keratoconjunctivitis (2)/rash (1)
Cheikh et al,^Citation36 2017	3	HL (2)	None (2)	NA	CR/CR	GVHD (3)/GVHD (3)	Death due to fungal infection (1)
Covut et al,^Citation44 2017	NA	HL (2)	None/GVHD (2)	12 m/NA	CR/PD	None/none	Death due to hepatic failure (1)

Notes: **One patient received a single dose of 100 mg, one received a low-dose regimen of 0.3–1 mg nivolumab per kg body weight weekly for a total of five infusions, and one received 2 injections (100 mg each). ¶Disease relapse occurred at an average of 1008 days from allo-HSCT (181, 389, and 2456 days).

Abbreviations: HL, Hodgkin’s lymphoma; AML, acute myelocytic leukemia; aGVHD, acute graft-versus-host disease; cGVHD, chronic graft-versus-host disease; interval, the interval between allo-HSCT and nivolumab administration; CR, complete remission; PR, partial remission; SD, disease stabilization; NA, not available.

Table 2 Studies on Nivolumab Use After Allo-HSCT

Study	N, n1, n2	Dose (mg/kg)	Interval (m)	Median Follow-Up (m)	ORR%	Response (%)	aGVHD,%	cGVHD,%	Prior GVHD, %&
Herbaux et al,^Citation45 2015	12, 12, 8	3	11	2	58	CR (25) PR (33)	17	0	100
Schoch et al,^Citation46 2016	9, 6, NA	NA	14.4	24	NA	NA	0	0	NA
Herbaux et al,^Citation26 2017	20,20,19	3	8.5/28.5*	12.3	95	CR (42) PR (52)	30	0	100
Haverkos et al,^Citation23 2017	31,28, 30	3	≥24	14	77	CR (50) PR (27)	19	32∮	39
Davids et al,^Citation47 2017	8, 8, 8	1,0.5§	NA	8	17	PR (17)	0	13	NA

Notes: &Patients who had nivolumab-related GVHD. *Patients who had nivolumab-induced GVHD vs. no nivolumab-induced GVHD (median, 8.5 months vs median, 28.5 months). ∮Four patients had overlap GVHD. §Six patients received 1 mg/kg and two patients received 0.5 mg/kg.

Abbreviations: N, total number of patients; n1, patients using nivolumab; n2, evaluable patients for the response; Interval, interval between allo-HSCT and nivolumab administration; ORR, objective response rate; CR, complete remission; PR, partial remission; allo-HSCT, allogeneic hematopoietic stem cell transplantation.

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