Activity of low dose nivolumab in patients with advanced squamous cell carcinomas and other cancers
Gauduchon, T.; Fayette, J.; Amini-Adle, M.; Neidhart-Berard, E.-M.; Brahmi, M.; Dufresne, A.; Dupont, M.; Coutzac, C.; De Bernardi, A.; Toussaint, P.; Mery, B.; Crumbach, L.; Ray-Coquard, I.; Dutour, A.; Castets, M.; Blay, J.-Y.; HEUDEL, P.
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Immune checkpoint inhibitors such as anti-PD1 antibodies are essential in cancer therapy. Emerging data suggest that lower doses may be effective and more economical, though further evidence is needed. We conducted a retrospective study at Centre Leon Berard to assess the efficacy and safety of low-dose nivolumab (20 mg every three weeks) in patients with advanced cancer, mainly squamous cell carcinomas (SCC). Between 2023 and 2024, 53 patients were treated, with a median age of 74 years; 39.6% were over 80. Most were male (64%) and had ECOG >1 (69.9%). Primary tumor sites included cutaneous SCC (34%), head and neck SCC (32%), and soft tissue sarcoma (15%). After a median follow-up of 8.3 months, median overall survival was 7.5 months. The objective response rate (ORR) was 20.8% overall, rising to 35.3% in cutaneous SCC and 23.5% in head and neck SCC-comparable to standard-dose nivolumab. Toxicity was manageable: 18.7% experienced immune-related adverse events, with only 3.7% grade 3. Low-dose nivolumab demonstrates encouraging efficacy and tolerability in a frail population, supporting its potential role in resource-limited settings. Prospective trials are warranted to confirm these findings in broader populations.
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