Abscopal-like Regression of Lung Metastases After Near-infrared Photoimmunotherapy Plus Nivolumab in Laryngeal Carcinoma.
Yoshiya Ishida, Ryota Yuasa, Koki Nakamuta et al.
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Case in brief
A man in his 60s with recurrent laryngeal squamous cell carcinoma, base-of-tongue involvement, and multiple pulmonary metastases had progressed after several treatments, including platinum- and pembrolizumab-containing regimens. After nivolumab was started, near-infrared photoimmunotherapy (NIR-PIT) was added for the base-of-tongue lesion. At 4 months, non-illuminated pulmonary and cervical lesions had decreased in size, meeting RECIST 1.1 criteria for partial response; regression deepened and persisted at 10 months. The illuminated lesion persisted despite repeat NIR-PIT. Adverse events were grade 2 facial and cervical edema and local pain.
What made this case unusual
Distant pulmonary metastases regressed during nivolumab plus local NIR-PIT, while the illuminated base-of-tongue lesion persisted. The pattern was described as abscopal-like, but a single case cannot establish that NIR-PIT caused the distant response.
Diagnostic / clinical pearl
Assess lesions outside the treatment field when evaluating response to local NIR-PIT combined with PD-1 blockade; distant regression may occur even when the illuminated lesion persists.
Why it matters
The observation provides a clinical rationale for formally investigating NIR-PIT–immune checkpoint inhibitor combinations in patients with distant metastases, without establishing efficacy or causality.