Definitive Chemoradiation Followed by Consolidation Immunotherapy for Unresectable Tracheal Squamous Cell Carcinoma:...

Tracheal cancer is a rare malignancy that is typically treated with a multimodal approach with surgery, radiation therapy, and chemotherapy. Despite the treatment options, outcomes can be poor, with a high risk of recurrence that can be life-threatening. We present the case of a 68-year-old male with unresectable squamous cell carcinoma (SCC) of the trachea treated with definitive concurrent chemoradiation (66 Gy and cisplatin), followed by consolidation immunotherapy with durvalumab. This treatment approach mirrors the regimen used in unresectable stage III non-small cell lung cancer (NSCLC) based on the PACIFIC trial. The patient began durvalumab six weeks after chemoradiation and received five cycles over ~2.5 months, but therapy was discontinued early due to immune-mediated colitis presenting with diarrhea. The immunotherapy-related autoimmune side effects were successfully managed. He has since undergone routine surveillance with serial positron emission tomography/computed tomography (PET/CT) imaging and clinical follow-up and remains disease-free three years post-treatment. This case demonstrates the potential benefit of adapting an NSCLC immunotherapy regimen to primary tracheal squamous cell carcinoma (SCC), which has no standardized post-chemoradiation immunotherapy protocol.