Case ReportExcellent Response to Nivolumab and Ipilimumab in MetastaticGastroesophageal Junction Squamous Carcinoma

Unresectable gastroesophageal junction (GEJ) cancers have a poor prognosis and limited treatment options. We report thecase of a patient with a Siewert class III gastroesophageal junction squamous carcinoma with metastatic spread into theliver who had an exceptional response to a combination therapy of nivolumab and ipilimumab despite being programmeddeath-ligand 1 (PD-L1) negative, microsatellite stable (MSS), and having a low tumor mutational burden. He initiallyexperienced disease progression on the chemotherapy regimens modified DCF and FOLFIRI resulting in limited functionalstatus, esophageal stent placement, and feeding tube placement. After about 6 months on nivolumab and ipilimumab, hehad near-complete disease resolution. He was able to return to his baseline functional status, as well as have theesophageal stent and feeding tube removed. Our case contributes to the value of exploring immunotherapy as an optionfor a variety of hard to treat cancers.