Case reportDurable complete remission with local therapies after neoadjuvant and adjuvant nivolumab in recurrent/metastatic head and neck cancerCabezas-Camarero, Santiagoa; Iglesias-Moreno, María Cruzb; Cerezo Druet, Elenac; Sotelo, Miguel J.d–f; Merino-Menéndez, Salomég; Cabrera-Martín, María Nievesh; Plaza-Hernández, José Carlosi; Pérez-Segura, Pedroa Author Information aMedical Oncology Department, Instituto de Investigación Sanitaria San Carlos (IdISSC), Hospital Clínico Universitario San Carlos bOtolaryngology-Head and Neck Surgery, Hospital Clínico Universitario San Carlos cRadiotherapy Department, Hospital Clínico Universitario San Carlos, Madrid, Spain dMedical Oncology Department, Aliada Cancer Center eMedical Oncology Department, Clínica San Felipe fMedical Oncology Department, Hospital María Auxiliadora, Lima, Perú gRadiology Department, Hospital Clínico Universitario San Carlos hNuclear Medicine Department, Hospital Clínico Universitario San Carlos, Hospital Clínico Universitario San Carlos iPathology Department, Hospital Clínico Universitario San Carlos, Madrid, Spain Correspondence to Santiago Cabezas-Camarero, MD, PhD, Head and Neck Cancer, Neuro-Oncology and Genetic Counseling Unit, Medical Oncology Department, Hospital Clínico Universitario San Carlos, Paseo del Profesor Martín Lagos S/N, 28040 Madrid, Spain, E-mail: [email protected], [email protected] Anti-Cancer Drugs: November 17, 2022 - Volume - Issue - 10.1097/CAD.0000000000001422 doi: 10.1097/CAD.0000000000001422 Buy PAP Metrics Abstract Up to 10–15% of patients with first-line recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) present with platinum-refractory disease. The anti-PD1 nivolumab is the first therapeutic option in this setting achieving a 19.2% objective response rate and a 7.7-month median overall survival (OS). Given the poor prognosis of platinum-refractory patients, those showing slow progressive disease with no functional status deterioration should maintain nivolumab beyond progression in the absence of severe or unmanageable toxicities. Another strategy is to use local therapies such as radiotherapy and surgical tumor resection in cases of oligometastatic or oligoprogressive disease. Both strategies may significantly improve disease control and OS in these populations. We present the case of a patient with platinum-refractory disease treated with first-line nivolumab beyond progression who achieved a durable complete response after palliative radiation and surgical resection of five tumor lesions. To our knowledge, this is the first reported case of an R/M HNSCC treated with such a strategy outside a clinical trial and contributes to the evidence for combining anti-PD1 agents and local therapies in selected patients with R/M HNSCC. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.