Complete Response to Nivolumab of Resected Adenocarcinoma NOS With Parotid Gland Origin and Lung Metastasis.

BACKGROUND/AIM: Salivary gland adenocarcinoma not otherwise specified (NOS) is classified under the 2017 WHO Classification of Head and Neck Tumors as a malignant neoplasm without the histological features characteristic of other cancer types. Japan's national health insurance program began covering nivolumab in March 2017 for the treatment of patients with recurrent or metastatic head and neck cancer, including salivary gland carcinoma, previously treated with platinum agents. Existing literature does not include cases of patients with salivary gland carcinoma, adenocarcinoma NOS or otherwise, who have achieved complete response to nivolumab.

CASE REPORT: Our patient was a 32-year-old woman. Following diagnosis of adenocarcinoma of a right accessory parotid gland, she underwent reconstructive surgery of the parotid gland followed by postoperative adjuvant therapy with radiotherapy and cisplatin. Multiple lung metastases were found 14 months thereafter. Given a history of cisplatin administration, she was treated with nivolumab. Computed tomography (CT) showed partial response after 5 months and complete response after 9 months of nivolumab treatment. Based on CT findings, the lung metastases remained absent 39 months after nivolumab treatment was halted due to the patient's plans for pregnancy.

CONCLUSION

Nivolumab may be an effective option for treating high-grade salivary gland carcinomas that recur or metastasize.