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Exceptional Response to Nivolumab in a 13-Year-Old Female with Metastatic HPV-Negative Cervical Carcinoma.

Abstract
Cervical carcinoma is associated with high-risk human papillomavirus (HPV) DNA integration and usually occurs after age 21 (peak 45 years), as reflected in screening guidelines. Between 1999 and 2008, cervical carcinoma rate in adolescents aged 15-19 years was 0.15 per 100,000. HPV-negative cervical carcinoma is rare in adolescents. The youngest previously reported case was 15 years old. Treatment options for cervical carcinoma are limited after first-line therapy. Immune checkpoint inhibitors blocking programmed death receptor (PD-1) and its ligand, PD-L1, have shown objective clinical responses and are tolerable in adults with gynecologic cancers. This class of agents is well tolerated in pediatric patients. PD-1/PD-L1 is commonly expressed in gynecologic cancers but its expression may not predict clinical response. We describe an exceptional response to single agent nivolumab postradiation therapy in a 13-year-old adolescent with poorly differentiated cervical carcinoma and widespread metastatic disease.
AuthorsJoseph H Oved, Ashley Graul, Robert A Burger, Lauren E Schwartz, M Carolina Reyes, Frank M Balis
JournalDNA and cell biology (DNA Cell Biol) Vol. 38 Issue 10 Pg. 1143-1146 (Oct 2019) ISSN: 1557-7430 [Electronic] United States
PMID31464522 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antineoplastic Agents, Immunological
  • Nivolumab
  • Carboplatin
  • Paclitaxel
Topics
  • Adolescent
  • Antineoplastic Agents, Immunological (therapeutic use)
  • Carboplatin (therapeutic use)
  • Carcinoma (secondary, surgery, therapy)
  • Female
  • Gamma Rays (therapeutic use)
  • Humans
  • Hysterectomy
  • Liver Neoplasms (secondary, surgery, therapy)
  • Lung Neoplasms (secondary, surgery, therapy)
  • Lymph Node Excision
  • Nivolumab (therapeutic use)
  • Ovariectomy
  • Paclitaxel (therapeutic use)
  • Papillomaviridae
  • Salpingectomy
  • Treatment Outcome
  • Uterine Cervical Neoplasms (pathology, surgery, therapy)

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