Phase 2 trial of neoadjuvant chemotherapy plus tislelizumab in locally advanced head and neck squamous cell carcinoma

A phase 2 trial at Tongji Medical College Hospital of Huazhong University of Science and Technology (Wuhan, China) evaluated neoadjuvant nab-paclitaxel plus carboplatin chemotherapy combined with tislelizumab (PD-1 inhibitor) in 33 patients with potentially resectable stage II-IVb head and neck squamous cell carcinoma (HNSCC). Patients received two cycles of neoadjuvant therapy followed by surgery. Primary endpoints were pathological complete response (pCR) rate and major pathological response (MPR) rate. The objective response rate was 72.7% and the R0 resection rate was 93.1%. The pCR rate was 44.8% and the MPR rate was 62.1%. The laryngeal preservation rate was 70.4%. With a median follow-up of 20.5 months, the 12- and 24-month event-free survival rates both were 93.1%. The pCR rate was significantly higher in patients with PD-L1 combined positive score ≥ 1 compared to those with CPS < 1. The authors conclude that neoadjuvant immunochemotherapy improves pathological response and organ preservation in potentially resectable locally advanced HNSCC.