RT Journal Article SR Electronic T1 HLA Class I Loss and Resistance to Immunotherapy in Pulmonary Metastasis of Hypopharyngeal Cancer JF In Vivo JO In Vivo FD International Institute of Anticancer Research SP 1753 OP 1759 DO 10.21873/invivo.14327 VO 40 IS 3 A1 MURAKAMI, AKIRA A1 YUKINO, KAORI A1 KOMOHARA, YOSHIHIRO A1 SHIMODA, YU A1 SAITO, HARUKI A1 FUJIWARA, YUKIO A1 ORITA, YORIHISA YR 2026 UL http://iv.iiarjournals.org/content/40/3/1753.abstract AB Background/Aim: Although immune checkpoint inhibitors (ICIs) can be remarkably effective in the treatment of unresectable recurrent or metastatic carcinoma of the head and neck, even in cases of a marked response, some lesions may remain partially refractory or new lesions may emerge. However, why ICIs sometimes produce such a patchy pattern of therapeutic effects remains unclear.Case Report: A 62-year-old patient with advanced hypopharyngeal squamous cell carcinoma who developed pulmonary metastasis after surgery followed by postoperative chemoradiotherapy presented to our department. After initiating ICI therapy, the patient initially achieved complete remission; however, a new pulmonary lesion subsequently appeared and was surgically removed. The patient has since remained in durable remission with continued long-term ICI therapy. Immunohistochemical analysis comparing the new pulmonary lesion with the original hypopharyngeal tumor revealed that cancer cells in the primary lesion were positive for HLA class I and b2-microglobulin, whereas staining for these antigens was negative in cancer cells of the recurrent pulmonary lesion. Cancer cells in the primary lesion exhibited ectopic expression of HLA class II, but no expression was detected in cancer cells of recurrent lesions.Conclusion: In the pulmonary lesion that did not respond to ICIs, a loss of HLA class I and b2-microglobulin expression was observed. These findings suggest that the reduced antigen-presenting capacity of cancer cells may contribute to immune escape.