Pathological regression patterns following neoadjuvant chemo-immunotherapy in head and neck squamous cell carcinoma: a pilot study
IntroductionNeoadjuvant chemoimmunotherapy (NACI) has drawn considerable attention in Head and neck squamous cell carcinoma (HNSCC) owing to its potential in functional preservation and treatment-failure reduction. Yet whether the surgical extent can be narrowed following NACI is largely debatable d...
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Frontiers Media S.A.
2025-08-01
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| author | Dikan Wang Dikan Wang Fanning Zeng Fanning Zeng Sien Zhang Sien Zhang Wanming Hu Yahui Wang Yahui Wang Daiqiao Ouyang Daiqiao Ouyang Bin Zeng Bin Zeng Guozhong Zeng Guozhong Zeng Jingyuan Li Jingyuan Li Guiqing Liao Guiqing Liao Yujie Liang Yujie Liang |
| author_facet | Dikan Wang Dikan Wang Fanning Zeng Fanning Zeng Sien Zhang Sien Zhang Wanming Hu Yahui Wang Yahui Wang Daiqiao Ouyang Daiqiao Ouyang Bin Zeng Bin Zeng Guozhong Zeng Guozhong Zeng Jingyuan Li Jingyuan Li Guiqing Liao Guiqing Liao Yujie Liang Yujie Liang |
| author_sort | Dikan Wang |
| collection | DOAJ |
| description | IntroductionNeoadjuvant chemoimmunotherapy (NACI) has drawn considerable attention in Head and neck squamous cell carcinoma (HNSCC) owing to its potential in functional preservation and treatment-failure reduction. Yet whether the surgical extent can be narrowed following NACI is largely debatable due to a potential non-centripetal tumor regression may result in scattered microfoci residing beyond the narrowed margin.MethodsIn this pilot study, we characterized the tumor regression pattern in a post-NACI HNSCC cohort using a whole-mount histopathological approach. The MRI examinations before and after NACI were used to evaluate the objective response rate (ORR).ResultsOf the 52 patients enrolled, the ORR was 75%. Pathological complete response (pCR) rate was 15.4%, and the major pathological response (MPR) rate was 40.4%. Two major regression patterns were identified in whole-mount tumor sections, centripetal regression and non-centripetal regression. Centripetal regression was observed in 37 patients (71.2%) and was subcategorized into complete regression (Ia, 15.4%), unifocal centripetal regression (Ib, 36.5%), and multifocal centripetal regression (Ic, 19.2%). Non-centripetal regression was seen in 15 patients (28.8%) and was subcategorized into scattered regression (IIa, 25.0%) and non-regression (IIb, 3.8%). Moreover, we found a pre-NACI CPS higher than 20 or post-NACI (18)F-FDG SUVmax reduction exceeding 50% were potential predictive factors for the centripetal regression pattern.DiscussionWe revealed for that centripetal regression was the predominant pattern of regression after NACI in HNSCC. Hence, our data presumably supports a reduced surgical extent in post-NACI HNSCC patients. Future studies should focus on identifying accurate predictive factors for the regression pattern, which may eventually assist in risk stratification and surgical decision making.ConclusionsThe pattern of tumor pathological regression after NACI for HNSCC is mainly divided into centripetal and non-centripetal regression, with the former accounting for the major portion of the regression. |
| format | Article |
| id | doaj-art-9bbdc76bb9de44c2b26f6252bf5840c6 |
| institution | Kabale University |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-08-01 |
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| series | Frontiers in Immunology |
| spelling | doaj-art-9bbdc76bb9de44c2b26f6252bf5840c62025-08-20T04:02:13ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-08-011610.3389/fimmu.2025.16274421627442Pathological regression patterns following neoadjuvant chemo-immunotherapy in head and neck squamous cell carcinoma: a pilot studyDikan Wang0Dikan Wang1Fanning Zeng2Fanning Zeng3Sien Zhang4Sien Zhang5Wanming Hu6Yahui Wang7Yahui Wang8Daiqiao Ouyang9Daiqiao Ouyang10Bin Zeng11Bin Zeng12Guozhong Zeng13Guozhong Zeng14Jingyuan Li15Jingyuan Li16Guiqing Liao17Guiqing Liao18Yujie Liang19Yujie Liang20Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaHospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaHospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Pathology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, ChinaHospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaHospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaHospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaHospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaHospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaHospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaHospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, ChinaIntroductionNeoadjuvant chemoimmunotherapy (NACI) has drawn considerable attention in Head and neck squamous cell carcinoma (HNSCC) owing to its potential in functional preservation and treatment-failure reduction. Yet whether the surgical extent can be narrowed following NACI is largely debatable due to a potential non-centripetal tumor regression may result in scattered microfoci residing beyond the narrowed margin.MethodsIn this pilot study, we characterized the tumor regression pattern in a post-NACI HNSCC cohort using a whole-mount histopathological approach. The MRI examinations before and after NACI were used to evaluate the objective response rate (ORR).ResultsOf the 52 patients enrolled, the ORR was 75%. Pathological complete response (pCR) rate was 15.4%, and the major pathological response (MPR) rate was 40.4%. Two major regression patterns were identified in whole-mount tumor sections, centripetal regression and non-centripetal regression. Centripetal regression was observed in 37 patients (71.2%) and was subcategorized into complete regression (Ia, 15.4%), unifocal centripetal regression (Ib, 36.5%), and multifocal centripetal regression (Ic, 19.2%). Non-centripetal regression was seen in 15 patients (28.8%) and was subcategorized into scattered regression (IIa, 25.0%) and non-regression (IIb, 3.8%). Moreover, we found a pre-NACI CPS higher than 20 or post-NACI (18)F-FDG SUVmax reduction exceeding 50% were potential predictive factors for the centripetal regression pattern.DiscussionWe revealed for that centripetal regression was the predominant pattern of regression after NACI in HNSCC. Hence, our data presumably supports a reduced surgical extent in post-NACI HNSCC patients. Future studies should focus on identifying accurate predictive factors for the regression pattern, which may eventually assist in risk stratification and surgical decision making.ConclusionsThe pattern of tumor pathological regression after NACI for HNSCC is mainly divided into centripetal and non-centripetal regression, with the former accounting for the major portion of the regression.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1627442/fullchemo-immunotherapyneoadjuvant therapyhead and neck squamous cell carcinoma (HNSCC)regression patternpathological response |
| spellingShingle | Dikan Wang Dikan Wang Fanning Zeng Fanning Zeng Sien Zhang Sien Zhang Wanming Hu Yahui Wang Yahui Wang Daiqiao Ouyang Daiqiao Ouyang Bin Zeng Bin Zeng Guozhong Zeng Guozhong Zeng Jingyuan Li Jingyuan Li Guiqing Liao Guiqing Liao Yujie Liang Yujie Liang Pathological regression patterns following neoadjuvant chemo-immunotherapy in head and neck squamous cell carcinoma: a pilot study Frontiers in Immunology chemo-immunotherapy neoadjuvant therapy head and neck squamous cell carcinoma (HNSCC) regression pattern pathological response |
| title | Pathological regression patterns following neoadjuvant chemo-immunotherapy in head and neck squamous cell carcinoma: a pilot study |
| title_full | Pathological regression patterns following neoadjuvant chemo-immunotherapy in head and neck squamous cell carcinoma: a pilot study |
| title_fullStr | Pathological regression patterns following neoadjuvant chemo-immunotherapy in head and neck squamous cell carcinoma: a pilot study |
| title_full_unstemmed | Pathological regression patterns following neoadjuvant chemo-immunotherapy in head and neck squamous cell carcinoma: a pilot study |
| title_short | Pathological regression patterns following neoadjuvant chemo-immunotherapy in head and neck squamous cell carcinoma: a pilot study |
| title_sort | pathological regression patterns following neoadjuvant chemo immunotherapy in head and neck squamous cell carcinoma a pilot study |
| topic | chemo-immunotherapy neoadjuvant therapy head and neck squamous cell carcinoma (HNSCC) regression pattern pathological response |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1627442/full |
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