Late-onset and relapsed cytokine release syndrome after nivolumab treatment in a patient with head and neck squamous cell carcinoma: a case report
Nivolumab, an anti-programmed death-1 (PD-1) receptor monoclonal antibody, has proven effective in treating platinum-resistant metastatic head and neck squamous cell carcinoma. Immune-related adverse events (irAEs) are well-known complications of PD-1 inhibitors. Meanwhile, cytokine release syndrome...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1508682/full |
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| author | Tomoyuki Otsuka Yoshiki Kojitani Fumio Imamura Junko Fukutake Minako Nishio Takashi Fujii Toshihiro Kudo |
| author_facet | Tomoyuki Otsuka Yoshiki Kojitani Fumio Imamura Junko Fukutake Minako Nishio Takashi Fujii Toshihiro Kudo |
| author_sort | Tomoyuki Otsuka |
| collection | DOAJ |
| description | Nivolumab, an anti-programmed death-1 (PD-1) receptor monoclonal antibody, has proven effective in treating platinum-resistant metastatic head and neck squamous cell carcinoma. Immune-related adverse events (irAEs) are well-known complications of PD-1 inhibitors. Meanwhile, cytokine release syndrome (CRS), a life-threatening immune-related adverse event, rarely develops due to nivolumab monotherapy. Here, we report a case of a 65-year-old man with squamous cell head and neck carcinoma of an occult primary origin who developed nivolumab-associated late-onset CRS that recurred. The patient was admitted with symptoms of fatigue, fever, hypotension, and respiratory distress. The diagnosis of CRS was supported by the elevated serum levels of interleukin-6 and ferritin, and the patient responded well to high-dose methylprednisolone. CRS recurred during steroid tapering, coinciding with an increased tumor burden; however, it was successfully managed with increased steroid dosing. Early detection and treatment with steroids are essential for the management of CRS. |
| format | Article |
| id | doaj-art-4f958a890cd84be4a93ca802e937e788 |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-4f958a890cd84be4a93ca802e937e7882025-02-07T06:49:27ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-02-011510.3389/fonc.2025.15086821508682Late-onset and relapsed cytokine release syndrome after nivolumab treatment in a patient with head and neck squamous cell carcinoma: a case reportTomoyuki Otsuka0Yoshiki Kojitani1Fumio Imamura2Junko Fukutake3Minako Nishio4Takashi Fujii5Toshihiro Kudo6Department of Medical Oncology, Osaka International Cancer Institute, Osaka, JapanDepartment of Medical Oncology, Osaka International Cancer Institute, Osaka, JapanDepartment of Medical Oncology, Osaka International Cancer Institute, Osaka, JapanDepartment of Head and Neck Surgery, Osaka International Cancer Institute, Osaka, JapanDepartment of Medical Oncology, Osaka International Cancer Institute, Osaka, JapanDepartment of Head and Neck Surgery, Osaka International Cancer Institute, Osaka, JapanDepartment of Medical Oncology, Osaka International Cancer Institute, Osaka, JapanNivolumab, an anti-programmed death-1 (PD-1) receptor monoclonal antibody, has proven effective in treating platinum-resistant metastatic head and neck squamous cell carcinoma. Immune-related adverse events (irAEs) are well-known complications of PD-1 inhibitors. Meanwhile, cytokine release syndrome (CRS), a life-threatening immune-related adverse event, rarely develops due to nivolumab monotherapy. Here, we report a case of a 65-year-old man with squamous cell head and neck carcinoma of an occult primary origin who developed nivolumab-associated late-onset CRS that recurred. The patient was admitted with symptoms of fatigue, fever, hypotension, and respiratory distress. The diagnosis of CRS was supported by the elevated serum levels of interleukin-6 and ferritin, and the patient responded well to high-dose methylprednisolone. CRS recurred during steroid tapering, coinciding with an increased tumor burden; however, it was successfully managed with increased steroid dosing. Early detection and treatment with steroids are essential for the management of CRS.https://www.frontiersin.org/articles/10.3389/fonc.2025.1508682/fullimmune checkpoint inhibitorimmune-related adverse eventcytokine release syndromehead and neck squamous cell carcinomacase report |
| spellingShingle | Tomoyuki Otsuka Yoshiki Kojitani Fumio Imamura Junko Fukutake Minako Nishio Takashi Fujii Toshihiro Kudo Late-onset and relapsed cytokine release syndrome after nivolumab treatment in a patient with head and neck squamous cell carcinoma: a case report Frontiers in Oncology immune checkpoint inhibitor immune-related adverse event cytokine release syndrome head and neck squamous cell carcinoma case report |
| title | Late-onset and relapsed cytokine release syndrome after nivolumab treatment in a patient with head and neck squamous cell carcinoma: a case report |
| title_full | Late-onset and relapsed cytokine release syndrome after nivolumab treatment in a patient with head and neck squamous cell carcinoma: a case report |
| title_fullStr | Late-onset and relapsed cytokine release syndrome after nivolumab treatment in a patient with head and neck squamous cell carcinoma: a case report |
| title_full_unstemmed | Late-onset and relapsed cytokine release syndrome after nivolumab treatment in a patient with head and neck squamous cell carcinoma: a case report |
| title_short | Late-onset and relapsed cytokine release syndrome after nivolumab treatment in a patient with head and neck squamous cell carcinoma: a case report |
| title_sort | late onset and relapsed cytokine release syndrome after nivolumab treatment in a patient with head and neck squamous cell carcinoma a case report |
| topic | immune checkpoint inhibitor immune-related adverse event cytokine release syndrome head and neck squamous cell carcinoma case report |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1508682/full |
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