JAMA Network JAMA Otolaryngology–Head & Neck Surgery : Pathologic Treatment Effect and Survival in HPV-Negative HNSCC Following Neoadjuvant Nivolumab
Jul 31, 2025
Adam J. Luginbuhl is a surgical oncologist at the Sidney Kimmel Comprehensive Cancer Center, specializing in immunotherapy for head and neck cancer. Jennifer M. Johnson, also from the same center, focuses on treating advanced cases with immunotherapy. They delve into the impact of neoadjuvant nivolumab on HPV-negative head and neck squamous cell carcinoma, discussing patient outcomes and the critical role of early treatment responses. The conversation highlights the evolving dynamics in tumor boards and the importance of personalized care in enhancing patient survival.
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Pathologic Response Predicts Survival
- Neoadjuvant immunotherapy before surgery can induce a pathologic response in head and neck squamous cell carcinoma (HNSCC).
- This pathologic treatment effect correlates with better long-term survival, especially in HPV-negative HNSCC patients.
Adaptive Surgical Timing Strategy
- Use adaptive surgical timing to assess patient response after initial immunotherapy doses.
- Proceed with surgery earlier for non-responders to avoid disease progression and extend treatment for responders.
Remarkable Patient Response Example
- A patient with advanced tongue cancer showed remarkable response after neoadjuvant nivolumab, downstaging from T3N3B to almost T0N0.
- This response allowed treatment de-escalation, avoiding radiation and continuing with adjuvant immunotherapy.