Neoadjuvant chemotherapy enhances tumor‐specific T cell immunity in patients with <scp>HPV</scp>‐associated oropharyngeal cancer

Samaniego, Castor; Friedman, Jay; Yang, X. B.; Badger, Christopher; Shaver, Timothy M.; Samankan, Shabnam; Thakkar, Punam; Goodman, Joseph; Joshi, Arjun S.; Allen, Clint

doi:10.1002/hed.27463

Cited by 2 publications

(2 citation statements)

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“…This is a de-escalation of locoregional treatment, unlike the up-front TORS approach, which required adjuvant RT in 89% of patients. 10 Recently, Samaniego et al 34 demonstrated that neoadjuvant chemotherapy induces HPV-specific T-cell immunity. This is likely contributing to the success of neoadjuvant chemotherapy approach prior to TORS, in addition to the direct cytotoxic effect of chemotherapy on the tumor.…”

Section: Description and Benefits Of Nectorsmentioning

confidence: 99%

Quality of Life After Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Oropharynx Cancer

Silver,

Bouganim,

Richardson

et al. 2024

JAMA Otolaryngol Head Neck Surg

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ImportanceEfforts are underway to deintensified treatment protocols for patients with human papillomavirus virus−associated oropharyngeal squamous cell carcinoma (HPV-OPSCC) to achieve similar excellent oncologic outcomes while reducing treatment-related adverse effects. Transoral robotic surgery (TORS) as primary treatment often requires adjuvant therapy due to the high incidence of nodal metastasis. Treatment with neoadjuvant chemotherapy followed by TORS and neck dissection (NECTORS), reserving radiation therapy for salvage, yields excellent oncologic outcomes.ObjectiveTo assess patient-reported quality of life (QOL) and functional outcomes among patients with HPV-OPSCC who undergo NECTORS.Design, Settings, and ParticipantsThis was a multicenter prospective cohort study of patients with HPV-OPSCC treated with the NECTORS protocol in 2017 to 2022. Consecutive patients with stage III or IVa HPV-OPSCC treated with NECTORS in 2017 to 2022 who had completed the primary QOL questionnaire at baseline and at least once during the 24-month follow-up period were included. Ninety-four patients were eligible, and 67 were included in the analyses.Outcome MeasuresQOL questionnaires at baseline, and at month 1, 3, 6, 12, 18, and 24 posttreatment. Global score on the 30-item European Organization for Research and Treatment of Cancer Core quality of life questionnaire (EORTC QLQ-C30) was the primary outcome; the head and neck extension module (EORTC QLQ-HN35); the MD Anderson Dysphagia Inventory for dysphagia-related QOL; and the Decision Regret Scale were also used. Paired t tests assessed change between the baseline and 12- or 24-month patient-reported outcomes.ResultsAmong the study population of 67 patients (median [range] age, 63 [58-67] years; 54 [80.6%] male) with HPV-OPSCC, the most frequent cancer subsites were palatine tonsil (41 [61%]) and base of tongue (26 [39%]); none required adjuvant RT. Global QOL at 24 months improved compared with baseline (mean difference, 9.49; 95% CI, 2.45 to 16.53). All EORTC QLQ-C30 functional scores returned to baseline or improved within 3 to 6 months posttreatment and remained stable at 24 months. EORTC QLQ-HN35 symptom scale scores improved or were stable at 24 months. The MD Anderson Dysphagia Inventory scores demonstrated no significant difference between baseline and month 12 for global scores (mean difference, 6.15; 95% CI, −4.18 to 16.49) and composite scores (mean difference, 2.73; 95% CI, −1.62 to 7.09). Median (range) score on the Decision Regret Scale was 5 of 100 (0-30), representing mild overall regret.Conclusion and RelevanceThe findings of this multicenter cohort study indicate that use of the NECTORS protocol is associated with excellent QOL outcomes. QOL measures returned to baseline levels or were better than baseline, which represents positive outcomes for patients with HPV-OPSCC who undergo this treatment regimen.

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Section: Description and Benefits Of Nectorsmentioning

confidence: 99%

Quality of Life After Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Oropharynx Cancer

Silver,

Bouganim,

Richardson

et al. 2024

JAMA Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

show abstract

“…Neoadjuvant chemotherapy is pivotal to surgery-only locoregional de-escalation in HPV-OPSCC. Neoadjuvant chemotherapy has been shown to enhance tumor-specific T-cell immunity in HPV-OPSCC . In the ECOG-ACRIN 3311 trial, 89% of patients with up-front transoral robotic surgery (TORS) received adjuvant RT (60%) or CRT (30%), with 11% having surgery only without adjuvant treatment .…”

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confidence: 99%

Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Oropharynx Cancer and Quality of Life—Reply

Sadeghi,

Mascarella,

Bouganim

2024

JAMA Otolaryngol Head Neck Surg

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Neoadjuvant chemotherapy enhances tumor‐specific T cell immunity in patients with HPV‐associated oropharyngeal cancer

Cited by 2 publications

References 38 publications

Quality of Life After Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Oropharynx Cancer

Quality of Life After Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Oropharynx Cancer

Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Oropharynx Cancer and Quality of Life—Reply

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