Nivolumab in platinum-refractory unresectable locally advanced squamous cell carcinoma of the head and neck: A case report and literature review

Head and neck squamous cell carcinoma (HNSCC) is associated with high mortality and poses a significant public health challenge. Platinum-based chemotherapy is a primary treatment modality; however, the median survival for patients experiencing recurrence within six months of platinum-based therapy is no more than six months. Immune checkpoint inhibitors, such as nivolumab and pembrolizumab, have revolutionized the treatment of platinum-refractory HNSCC since their FDA approval in 2016. This case report highlights the successful use of nivolumab in a patient with platinum-refractory, unresectable HNSCC, achieving long-term survival of over six years. The patient demonstrated a significant tumor reduction and stabilization of disease, followed by successful surgical management of recurrent lymph node growth. This case underscores the potential for durable responses with nivolumab, even in the absence of PD-L1 testing, and highlights the integration of immunotherapy with surgery as a personalized treatment strategy. The findings contribute to the growing body of real-world evidence supporting the use of immune checkpoint inhibitors in platinum-refractory HNSCC.