Abstract

BackgroundOn the basis of phase III CheckMate 141 results, nivolumab was approved for recurrent or metastatic head and neck cancer after undergoing platinum-containing chemotherapy in Japan. This post-marketing surveillance aimed to evaluate the safety and effectiveness of nivolumab for head and neck cancer in the real-world setting.MethodsAll patients with head and neck cancer who planned to receive nivolumab were centrally registered. This study monitored 607 patients for 6 months to assess nivolumab’s safety, especially treatment-related adverse events (TRAEs) of special interest, and effectiveness.ResultsTRAEs occurred in 36.1% patients, with no new safety signals. The most common TRAEs with grade ≥ 3 were interstitial lung disease (1.2%), diarrhea (0.8%), and hepatic function abnormal (0.7%). Meanwhile, thyroid dysfunction (10.2%), hepatic dysfunction (5.3%), and interstitial lung disease (4.1%) were the most common TRAE categories of special interest. Although the median time to the onset of each TRAE category of special interest was mostly 1–2 months, most of them occurred throughout the observation period; nonetheless, the majority of patients recovered or remitted. The 6-month survival rate was 55.9%.ConclusionJapanese patients with head and neck cancer treated with nivolumab in the real-world setting manifested no new safety signals.Clinical Trial Registrationclinicaltrials.jp: JapicCTI-184071.

Highlights

  • Nivolumab is the first humanized monoclonal antibody against human programmed death-1 (PD-1) [1]

  • We evaluated the incidence of treatment-related adverse events (TRAEs) of special interest that are specified in the Risk Management Plan of nivolumab based on previous clinical trials and post-marketing surveillance [4, 6]

  • From March 24, 2017, to March 31, 2020, 5944 patients with head and neck cancer were registered; we analyzed 632 patients who planned to start nivolumab treatment by June 30, 2017, because the prespecified number of patients to be included in the study were assembled (Fig. 1)

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Summary

Introduction

Nivolumab is the first humanized monoclonal antibody against human programmed death-1 (PD-1) [1]. As part of the approval condition, the Japanese Ministry of Health, Labor and Welfare requested the manufacturer to conduct a post-marketing surveillance for all cases of nivolumab treatment for head and neck cancer This prospective study evaluated the safety and effectiveness of nivolumab treatment in patients with head and neck cancer in the real-world setting in Japan. On the basis of phase III CheckMate 141 results, nivolumab was approved for recurrent or metastatic head and neck cancer after undergoing platinum-containing chemotherapy in Japan. This post-marketing surveillance aimed to evaluate the safety and effectiveness of nivolumab for head and neck cancer in the real-world setting.

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