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Neoadjuvant chemoimmunotherapy shows major pathological response and low recurrence in head and neck squamous cell carcinoma

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Abstract

Background

The study aimed to investigate the efficacy and survival outcomes of neoadjuvant chemotherapy combined with programmed cell death protein 1 (PD-1) blockade (neoadjuvant chemoimmunotherapy) for patients with resectable head and neck squamous cell carcinoma (HNSCC).

Methods

A retrospective analysis was conducted. Patients with initially diagnosed, resectable HNSCCs who received the neoadjuvant chemoimmunotherapy and radical surgery were included. Correlation analysis between patients’ clinical characteristics and pathological responses, and survival analysis were performed.

Results

A total of 79 patients were included. The majority of patients (55, 69.6%) were diagnosed at locally advanced stages and most of them (58, 73.4%) had tumor located at the oral cavity. Nearly half of patients (35, 44.3%) received two cycles of neoadjuvant chemoimmunotherapy and the rest had three or more cycles. The R0 resection rate was 98.7%. In the pathological evaluation, 53.1% of patients reached pathological complete responses or major pathological responses. After a median follow-up of 17.0 months, the 1-year disease-free survival (DFS) and overall survival (OS) rates were 87.2% and 97.4%, respectively. The pathological response showed a significantly positive association with survival benefits (p < 0.001). Patients with human papillomavirus (HPV)-positive oropharyngeal cancer had the best pathological response and survival outcomes. Besides, history of radiation at head and neck region and poor pathological response were found to be independent risk factors of DFS for patients receiving such treatments.

Conclusion

Neoadjuvant chemoimmunotherapy of HNSCC showed high rate of pathological response and low recurrence rate, holding promise for becoming the new standard of care for resectable HNSCC.

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Availability of data and materials

The original contributions presented in the study are included in the article/supplementary material. Further inquiries can be directed to the corresponding authors.

Abbreviations

AJCC:

American Joint Committee on Cancer

CT:

Computer tomography

CI:

Confidence interval

DFS:

Disease-free survival

HNSCC:

Head and neck squamous cell carcinoma

HPV:

Human papillomavirus

HR:

Hazard ratio

IHC:

Immunohistochemistry

MPR:

Major pathological response

MRI:

Magnetic resonance imaging

OS:

Overall survival

pCR:

Pathological complete response

PD-1:

Programmed cell death protein 1

PPR:

Partial pathological response

NPR:

No pathological response

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Funding

This study was supported by the Natural Science Foundation of Guangdong Province (2023A1515010464). The funding source has no role in study design, the collection, analysis and interpretation of data, the writing of the report, or the decision to submit the article for publication.

Author information

Author notes

  1. Shida Yan, Lili Liu and Xing Zhang contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Department of Head and Neck, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China

    Shida Yan, Xing Zhang, Wenmei Jiang, Xianlu Gao, Ankui Yang, Xuekui Liu, Wenkuan Chen, Yanfeng Chen, Hui Li, Qiaohong Lin, Menghua Li, Jingtao Chen, Quan Zhang, Shuwei Chen & Ming Song

  2. Department of Pathology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China

    Lili Liu & Lijun Wei

  3. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, China

    Shida Yan, Lili Liu, Xing Zhang, Lijun Wei, Wenmei Jiang, Xianlu Gao, Ankui Yang, Xuekui Liu, Wenkuan Chen, Yanfeng Chen, Hui Li, Qiaohong Lin, Menghua Li, Jingtao Chen, Quan Zhang, Shuwei Chen & Ming Song

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  1. Shida Yan
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Contributions

(I) Conception and design: SY, QZ, SC, MS. (II) Data acquisition: AY, XL, WC, YC, QZ, SC, MS. (III) Quality control of data and algorithms: LW, WJ, XG, HL, QL, ML, JC. (IV) Data analysis and interpretation: SY, LL, XZ, LW, WJ, XG. (V) Statistical analysis: SY, LL, XZ. (VI) Manuscript preparation: SY. (VII) Manuscript editing: SY, LL, XZ, QZ, SC, MS. (VIII) Manuscript review: SY, QZ, SC, MS. All authors contributed to the article and approved the submitted version.

Corresponding authors

Correspondence to Quan Zhang, Shuwei Chen or Ming Song.

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Conflict of interests

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethics approval

This study was performed in accordance with the Declaration of Helsinki and approved to waive informed patient consent by the Institutional Review Board of Sun Yat-sen University Cancer Center (Approval Number B2022-528-01) due to the retrospective, observational and non-interventional study.

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Yan, S., Liu, L., Zhang, X. et al. Neoadjuvant chemoimmunotherapy shows major pathological response and low recurrence in head and neck squamous cell carcinoma. Clin Transl Oncol 26, 1192–1202 (2024). https://doi.org/10.1007/s12094-023-03342-y

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