Related Experiment Video
Updated: May 10, 2026

In Vitro Modeling of Cancerous Neural Invasion: The Dorsal Root Ganglion Model
Published on: April 12, 2016
Perineural Invasion and Survival in Pembrolizumab-Treated Head and Neck Squamous Cell Carcinoma
Angeline A Truong1,2, Savinnie Ho1, Rex H Lee1
1Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.
Objective:
To determine the relationship between perineural invasion and 6-month progression-free survival (PFS)/2-year overall survival (OS) among patients with recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) on pembrolizumab.
Methods:
This study was a retrospective, observational study performed at a tertiary care academic center. Participants included patients with oral cavity, oropharynx, hypopharynx, and laryngeal head and neck squamous cell carcinoma who began pembrolizumab treatment at UCSF between May 2016 and May 2022. The primary outcome was 6-month progression-free survival and 6-month time-to-progression (TTP). The secondary outcome was 2-year overall survival. Disease progression was determined using radiographic criteria, adopted from the Response Evaluation Criteria in Solid Tumors.
Results:
One hundred and thirty-three patients with HNSCC were included. Immune checkpoint inhibitor (ICI) indication was recurrence/metastasis for all patients. Forty (30%) patients had perineural invasion. On univariate analysis, patients with perineural invasion were more likely to have worse 6-month PFS (p = 0.011). After controlling for number of metastatic organs, receipt of concurrent systemic therapy, age, and PDL-1 status, presence of perineural invasion was associated with worse 6-month PFS [HR 3.33 (1.32, 8.41), p = 0.011] and 6-month time to progression (TTP) [HR 2.14 (1.09, 7.38), p = 0.032], but was not significantly associated with 2-year OS [HR 1.35 (0.57, 3.19), p = 0.498].
Conclusion:
Presence of perineural invasion is associated with poorer 6-month progression-free survival on ICI in patients with HNSCC. Future studies should further explore how perineural invasion may alter response to immunotherapy.
Related Concept Videos
Tumor Progression
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
Treatment Resistant Cancers
Cancer Cell Migration through Invadopodia
Tumor Immunotherapy

