ORIGINAL RESEARCH article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
This article is part of the Research TopicBreaking Barriers: New Frontiers in Immunotherapy for Resistant CancersView all 7 articles
Efficacy of neoadjuvant pembrolizumab combined with paclitaxel and cisplatin in locally advanced oropharyngeal and hypopharyngeal squamous cell carcinoma: a retrospective study
Provisionally accepted
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
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Objective: This retrospective study aims to evaluate the efficacy and safety of pembrolizumab combined with paclitaxel and cisplatin (ICI+TP) in the treatment of locally advanced oropharyngeal and hypopharyngeal squamous cell carcinoma (OPHSCC). Methods: Patients with locally advanced OPHSCC who received ICI+TP, cetuximab with paclitaxel-cisplatin (CET+TP), or paclitaxel-cisplatin alone (TP) were reviewed. Radiographic and pathological response rates, transoral surgery rates, and survival outcomes were assessed. Results: A total of 83 patients were enrolled in this study, with 23 subjected to ICI+TP, 31 to CET+TP, and 29 to TP. Compared with TP, ICI+TP yielded superior clinical outcomes: a higher objective response rate (ORR) (91.3% vs. 55.2%, p<0.05), greater transoral surgery feasibility (91.3% vs. 34.5%, p<0.05), lower tracheostomy incidence (26.1% vs. 79.3%, p<0.05). Among hypopharyngeal carcinoma patients, ICI+TP achieved an ORR of 100%, outperforming both CET+TP (62.5%) and TP (51.9%). The transoral surgery rate reached 89.5% (vs. 29.6% with TP, p<0.05) while tracheostomy requirements were reduced (21.1% vs. 85.2%, p<0.05). Notably, ICI+TP produced significantly higher primary tumor pathological complete response rates than CET+TP (57.9% vs. 20.8%, p<0.05). Median follow-up was 10 months for ICI+TP, 13 months for CET+TP, and 24 months for TP. Neither progression-free nor overall survival showed significant improvement among the three groups. Conclusion: In locally advanced OPHSCC, neoadjuvant pembrolizumab combined with paclitaxel and cisplatin showed a higher ORR and increased transoral surgery rates while preserving laryngeal function, with no increase in severe treatment-related adverse events, demonstrating favorable efficacy and safety profiles.
Keywords: locally advanced oropharyngeal and hypopharyngeal cancer, immune checkpoint inhibitors, Neoadjuvant Therapy, chemoimmunotherapy, Transoral surgery
Received: 22 Aug 2025; Accepted: 06 Nov 2025.
Copyright: © 2025 Tang, Lin, Wu and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Gongbiao Lin, lingongbiao@fjmu.edu.cn
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