Pathologic Response After Neoadjuvant Chemoimmunotherapy in Head and Neck Squamous Cell Carcinoma

Area of Science:

• Oncology
• Immunotherapy
• Head and Neck Cancer

Background:

• Locally advanced head and neck squamous cell carcinoma (HNSCC) treatment outcomes require improvement.
• Neoadjuvant immunotherapy (NAI) shows promise but has modest pathologic response rates with single-agent regimens.

Purpose of the Study:

• To compare pathologic response rates between neoadjuvant immunotherapy (NAI) and neoadjuvant chemoimmunotherapy (NACI) in resectable HNSCC.
• To evaluate the efficacy of combination therapy versus single-agent immunotherapy in a real-world setting.

Main Methods:

• Retrospective cohort study of adult patients with resectable HNSCC.
• Comparison of outcomes between patients receiving NAI and NACI prior to surgery.
• Propensity score-adjusted analyses to control for baseline differences.

Main Results:

• Neoadjuvant chemoimmunotherapy (NACI) was associated with significantly higher rates of pathologic complete response (pCR) or major pathologic response (MPR) (67%) compared to neoadjuvant immunotherapy (NAI) alone (3.6%).
• Propensity score-adjusted analysis showed NACI had substantially higher odds of achieving pCR or MPR (OR, 29.1).
• Treatment was generally well-tolerated with minimal impact on surgical timing.

Conclusions:

• Neoadjuvant chemoimmunotherapy demonstrates superior pathologic response rates compared to neoadjuvant immunotherapy alone in resectable HNSCC.
• Combination regimens may play a crucial role in improving tumor response for HNSCC.
• Further prospective trials are warranted to confirm survival benefits.