Abstract 51P
Background
The purpose of this article is to assess the feasibility, functional preservation rate, response rate, and toxicity of experimentally applying a robust combination induction regimen (PD-1 inhibitors combined with targeted therapy and chemotherapy) in locally advanced head and neck squamous cell carcinoma (LASCCHN).
Methods
Between January 2022 and April 2024, we attempted a strong regimen for patients with LASCCHN, including a PD-1 inhibitor combined with cetuximab/nivolumab, along with paclitaxel and platinum-based chemotherapy for a total of 2 to 4 cycles. Following the regimen, treatments such as surgery and radiotherapy will be completed.
Results
A total of 18 patients were included, 5 had tonsillar cancer, and 13 had hypopharyngeal or laryngeal cancers. 14 patients (85.0%) were clinically staged as IVA-B (AJCC 8th edition). After induction treatment, 17 patients achieved partial response (PR), with 11 patients showing imaging remission exceeding PR. However, 2 patients died—one due to gastrointestinal bleeding and the other due to bone marrow suppression. Among the 9 patients who underwent radical surgery after induction therapy, 4 (44.4%) achieved PCR to the primary tumor, graded as TRG: grade 1. Additionally, 3 patients (33.3%) achieved major pathological response (MPR), graded as TRG: grade 3, but 2 patients exhibited almost no pathological response, graded as TRG: grade 5. Of the 18 patients, 3 received radical concurrent chemoradiotherapy, while 2 received postoperative adjuvant chemoradiotherapy. The organ preservation rate was 93.7%, with only 1 patient undergoing total laryngectomy, graded as TRG: grade 5. No serious perioperative complications were observed. The median follow-up time was 13 months, with a 1-year PFS rate of 82.1% and OS rate of 88.9%. During follow-up, the pathological organ function of patients was retained and protected.
Conclusions
Incorporating immune checkpoint inhibitors and targeted therapy into neoadjuvant chemotherapy for LASCCHN can achieve strong remission rates, effectively preserve organ functions, with manageable toxicity and no increase in surgery or postoperative radiotherapy-related complications.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.