Low-dose nivolumab and cabozantinib in recurrent intestinal-type papillary adenocarcinoma of the sinonasal region.

Abstract

Intestinal-type sinonasal adenocarcinoma is a rare epithelial malignancy primarily treated with surgery and chemoradiation. The combination of low-dose immunotherapy and a tyrosine kinase inhibitor in recurrent disease has not been previously studied.A man in his 20s with papillary adenocarcinoma of the sinonasal region, following surgical resection, was treated with six cycles of concurrent chemoradiotherapy, followed by four cycles of docetaxel, cisplatin and capecitabine. While on treatment, he was found to have extensive residual disease and he was started on low-dose nivolumab and cabozantinib. Repeat imaging after ten months of treatment revealed a significant reduction in lesions.Non-squamous head and neck cancers are often excluded from major trials, and the effect of immunotherapy in these histologies is poorly understood. The response seen with low-dose immunotherapy underscores the need for further research in this setting.

• Authors: Zachariah Thomas, Prashant Jambunathan, Anjali Jibi, Ajoy Oommen John, Ashish Singh
• Journal: BMJ case reports (BMJ Case Rep) Vol. 16 Issue 11 (Nov 03 2023) ISSN: 1757-790X [Electronic] England
• PMID: 37923331 (Publication Type: Case Reports, Journal Article)
• Copyright: © BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• cabozantinib
• Cisplatin
• Nivolumab

Topics

• Humans
• Male
• Adenocarcinoma (drug therapy)
• Adenocarcinoma, Papillary (drug therapy)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Carcinoma, Squamous Cell (pathology)
• Chemoradiotherapy (methods)
• Cisplatin
• Head and Neck Neoplasms (drug therapy)
• Nivolumab (therapeutic use)
• Adult