Efficacy and safety of neoadjuvant immune checkpoint inhibitors combined with chemotherapy in locally advanced hypopharyngeal squamous cell carcinoma: a retrospective analysis

Cancer research · Head and neck squamous cell carcinoma

Neoadjuvant PD‑1 inhibitor combined with chemotherapy induces significant radiological and pathological responses in patients with locally advanced hypopharyngeal cancer, effectively improving larynx‑preserving surgery rate and progression‑free survival with a favorable safety profile.

This retrospective analysis evaluated the efficacy and safety of neoadjuvant PD‑1 inhibitors (tislelizumab, pembrolizumab, camrelizumab, or nivolumab) in combination with nab‑paclitaxel plus cisplatin in 75 patients with locally advanced (stage III‑IVA) hypopharyngeal squamous cell carcinoma. All patients received ≥2 cycles of neoadjuvant immunochemotherapy, followed by radical surgery and adjuvant radiotherapy. Objective response rate (ORR) was 77.3 %, major pathological response (MPR) 78.7 %, pathological complete response (pCR) 17.3 %, and larynx‑preserving surgery rate 86.7 %. With a median follow‑up of 26 months, 12‑month and 24‑month overall survival were 93.3 % and 76.0 % respectively, and progression‑free survival (PFS) were 92.0 % and 76.0 % respectively. The safety profile was favorable, with no grade 3‑5 treatment‑related adverse events observed.

The study demonstrates that adding PD‑1 inhibitors to chemotherapy before surgery can achieve high tumor regression, preserve laryngeal function, and prolong remission in hypopharyngeal squamous cell carcinoma, potentially offering an alternative to radical laryngectomy with acceptable toxicity.

Evidence level: Sejtvonalas. Laboratóriumi sejtekben vizsgálták.

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