Pre-surgery chemo-immunotherapy linked to stronger tumor responses

In New York City, Ethan A. Gomez and colleagues at the Icahn School of Medicine at Mount Sinai compared what happened inside tumors before surgery. Among 86 real-world patients with resectable head and neck squamous cell carcinoma, the combination of chemotherapy and immunotherapy was associated with a major or complete pathologic response in 67% of patients receiving both treatments.

The comparison was stark. With immunotherapy alone, the same outcome occurred in 3.6% of recipients. The researchers assessed tissue removed during surgery: a pathologic complete response means no viable tumor remained, while a major pathologic response means 10% or less viable tumor remained. Across the full study population, 29% achieved a complete response and 17% a major response.

After adjustment for differences between the patient groups using propensity scores, chemoimmunotherapy was associated with 29.1 times higher odds of achieving a complete or major response. The treatment was generally well tolerated, and few operations were delayed because of adverse events.

And concretely? For people whose head and neck cancer can be surgically removed, adding chemotherapy to preoperative immunotherapy could mean substantially more tumor destruction before the operation, according to this real-world comparison.

The evidence still has a clear boundary. This was a comparison involving 86 patients, and Scott Roof, a Mount Sinai co-author, said larger samples and additional testing are required. The study therefore points toward a more personalized treatment strategy without establishing the combination as the standard for every patient.