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CASE REPORT article

Front. Oncol.
Sec. Head and Neck Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1508682
This article is part of the Research Topic Overcoming Therapeutic Resistance in Head and Neck Squamous Cell Carcinoma View all 5 articles

Late-Onset and Relapsed Cytokine Release Syndrome after Nivolumab Treatment in a Patient with Head and Neck Squamous Cell Carcinoma: A Case Report

Provisionally accepted
Tomoyuki Otsuka Tomoyuki Otsuka *Yoshiki Kojitani Yoshiki Kojitani Fumio Imamura Fumio Imamura Junko Fukutake Junko Fukutake Minako Nishio Minako Nishio Takashi Fujii Takashi Fujii Toshihiro Kudo Toshihiro Kudo
  • Osaka International Cancer Institute, Osaka, Japan

The final, formatted version of the article will be published soon.

    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.

    Keywords: Immune checkpoint inhibitor, Immune-related adverse event, cytokine release syndrome, Head and neck squamous cell carcinoma, case report

    Received: 09 Oct 2024; Accepted: 22 Jan 2025.

    Copyright: © 2025 Otsuka, Kojitani, Imamura, Fukutake, Nishio, Fujii and Kudo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Tomoyuki Otsuka, Osaka International Cancer Institute, Osaka, Japan

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