Department of Otolaryngology Head and Neck Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Hum Vaccin Immunother. 2022 Nov 30;18(6):2093075. doi: 10.1080/21645515.2022.2093075. Epub 2022 Jul 25.
Metastasis of head and neck squamous cell carcinoma rarely occurs in hepatic cancer and has a poor prognosis (median survival of 4 months). The efficacy of immunotherapy for these patients remains unknown. Herein, we present a patient with hypopharyngeal carcinoma metastasis to the liver with and mutations together with a combined positive score of 70. The tumor invaded the abdominal wall, liver, inferior vena cava and retroperitoneal lymph nodes. The patient was treated with pembrolizumab combined with cisplatin and 5-FU for four cycles and has been maintained on pembrolizumab monotherapy until now. The patient achieved a near complete response of hepatic and subcutaneous metastases, and the tumor thrombus disappeared completely. The patient developed grade I rashes on the trunk, which were considered immune-related adverse events; thus, the patient presented a significant tumor response and good tolerance to the therapeutic strategy. On the basis of this observation, pembrolizumab-based therapeutic strategies may be an effective alternative for metastatic hypopharyngeal carcinoma and may prolong overall survival and progression-free survival, which should be confirmed by more patients in the future. Immune-related adverse events also need attention.
头颈部鳞状细胞癌转移至肝脏的情况较为罕见，且预后较差（中位生存期为 4 个月）。这些患者的免疫治疗效果尚不清楚。在此，我们报告 1 例下咽癌肝转移患者，其存在 和 突变，且共同阳性评分（combined positive score，CPS）为 70。肿瘤侵犯腹壁、肝脏、下腔静脉和腹膜后淋巴结。该患者接受了 4 个周期的帕博利珠单抗联合顺铂和 5-FU 治疗，并一直维持帕博利珠单抗单药治疗至今。患者肝内和皮下转移病灶接近完全缓解，肿瘤血栓完全消失。患者躯干部出现 1 级皮疹，考虑为免疫相关不良事件；因此，患者对该治疗策略表现出显著的肿瘤缓解和良好的耐受。基于这一观察结果，基于帕博利珠单抗的治疗策略可能是转移性下咽癌的有效替代方案，可能延长总生存期和无进展生存期，未来需要更多患者来证实这一结果。免疫相关不良事件也需要关注。
