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Updated: Aug 15, 2025
07:29
Intramucosal Inoculation of Squamous Cell Carcinoma Cells in Mice for Tumor Immune Profiling and Treatment Response Assessment
Published on: April 22, 2019
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Response to Neoadjuvant Targeted Therapy in Operable Head and Neck Cancer Confers Survival Benefit
Marco A Mascarella1,2,3, Tolani F Olonisakin1,4, Purva Rumde1
1Division of Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Summary
Neoadjuvant targeted therapy in head and neck cancer improved survival by downstaging tumors. This approach also reduced circulating tumor markers, indicating a positive response to treatment.
Area of Science:
- Oncology
- Head and Neck Cancer Research
- Neoadjuvant Therapy
Background:
- Neoadjuvant therapy offers a preoperative window for personalized cancer treatment.
- Evaluating treatment response during this window can guide individualized care strategies.
Purpose of the Study:
- To determine if response to neoadjuvant therapy in operable head and neck squamous cell carcinoma (HNSCC) improves survival outcomes.
- To investigate the correlation between pathologic downstaging and survival benefits.
Main Methods:
- Pooled analysis of 92 treatment-naïve patients with operable HNSCC from three clinical trials (2009-2020).
- Neoadjuvant regimens included EGFR inhibitors or anti-ErbB3 antibody therapy within 28 days of surgery.
- Compared clinical to pathologic stage migration with disease-free survival (DFS) and overall survival (OS) using multivariable Cox regression. Analyzed circulating tumor markers.
Main Results:
- Pathologic downstaging occurred more frequently with neoadjuvant targeted therapy (P = 0.048).
- Patients with pathologic downstage migration showed significantly higher OS (89.5%) compared to no stage change (58%) or upstage (40%) (P = 0.003).
- Downstage migration was a positive prognostic factor for OS (HR, 0.22) and correlated with decreased circulating SOX17 and TAC1 (P = 0.0078).
Conclusions:
- Brief neoadjuvant therapy achieved pathologic downstaging in a subset of HNSCC patients.
- Pathologic downstaging was associated with significantly improved DFS and OS.
- Decreased circulating methylated SOX17 and TAC1 levels were observed following successful neoadjuvant therapy.
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