Neoadjuvant tislelizumab combined with chemotherapy in locally advanced oral or oropharyngeal squamous cell carcinoma: a real-world retrospective study

Wen-Jie Wu; Qian Liu; Pu-Gen An; Lin Wang; Jian-Yun Zhang; Yan Chen; Tong Zhang; Jie Zhang

doi:10.3389/fimmu.2023.1282629

Neoadjuvant tislelizumab combined with chemotherapy in locally advanced oral or oropharyngeal squamous cell carcinoma: a real-world retrospective study

Front Immunol. 2023 Nov 14:14:1282629. doi: 10.3389/fimmu.2023.1282629. eCollection 2023.

Authors

Wen-Jie Wu^{1

2

3}, Qian Liu^{1

2

3}, Pu-Gen An^{1

2

3}, Lin Wang^{1

2

3}, Jian-Yun Zhang^{2

3

4}, Yan Chen^{2

3

4}, Tong Zhang⁵, Jie Zhang^{1

2

3}

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
² National Center of Stomatology & National Clinical Research Center for Oral Diseases, Beijing, China.
³ Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China.
⁴ Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, China.
⁵ Departmet of Oncology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.

Abstract

Objectives: The treatment of locally advanced oral or oropharyngeal squamous cell carcinoma (LAOOPSCC) is surgery and radiotherapy or chemoradiotherapy but with unsatisfactory survival rate. Neoadjuvant programmed death-1 (PD-1) therapy are being used in several clinical trials. Therefore, in this retrospective study we aimed to determine the feasibility of neoadjuvant tislelizumab plus chemotherapy followed by surgery for LAOOPSCC.

Materials and methods: The clinical data of 33 patients with LAOOPSCC who received neoadjuvant PD-1 inhibitors and chemotherapy between April 2021 and October 2022 were retrospectively analyzed. Patients with stage III-IV LAOOPSCC received tislelizumab, albumin-bound paclitaxel, and cisplatin every 3 weeks (Q3W) for two cycles, followed by surgery and adjuvant radiotherapy or concurrent chemoradiotherapy. A median follow-up period was 20 months.

Results: The objective response rate (ORR) was 66.7%, with the major pathological response (MPR) rate at 54.5%, and the pathological complete response (pCR) rate was 33.3%. Sixteen patients underwent limited surgeries, and 15 patients were remitted from undergoing mandibulectomy and 9 patients were remitted from undergoing near total glossectomy or total glossectomy. A significant difference in the overall survival (OS) and disease-free survival (DFS) was observed in patients who achieved major pathological response (MPR) than who did not. The most common adverse events in neoadjuvant therapy were alopecia, decreased appetite or anorexia, leukopenia, and fatigue.

Conclusion: Neoadjuvant PD-1 inhibitors combined with chemotherapy are feasible and safe, with a high pathological response and possible organ preservation in oral or oropharyngeal squamous cell carcinoma. However, further studies with a larger cohort of patients and longer follow-up period is required to strengthen our findings and evaluate the survival benefits of the treatment.

Keywords: chemotherapy; head and neck; immunotherapy; neoadjuvant; squamous cell carcinoma.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Head and Neck Neoplasms*
Humans
Immune Checkpoint Inhibitors / adverse effects
Neoadjuvant Therapy*
Retrospective Studies
Squamous Cell Carcinoma of Head and Neck / drug therapy

Substances

tislelizumab
Immune Checkpoint Inhibitors

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Beijing Xisike Clinical Oncology Research Foundation (Y-MSDPU2022-0547), National clinical key discipline construction project (PKUSSNKP-202115) and the National Key Research and Development Program of China (2022YFC2504200, 2022YFC2406300).