Pathological mechanisms and advances in neoadjuvant PD-1 blockade combined with chemotherapy for head and neck cancer

Abstract In the most recent edition of Holistic Integrative Oncology , a study by Han and colleagues revealed that combining neoadjuvant programmed cell death 1 (PD-1) blockade with chemotherapy is effective for treating locally advanced head and neck squamous cell carcinoma. The retrospective analysis included 51 patients. The participants were assigned to treatment with neoadjuvant chemotherapy (NAC) alone or NAC combined with pembrolizumab. The study compared several outcomes between the two groups, including pathological complete response and objective response rates, delays in surgery, and toxicity. The results indicated that NAC combined with pembrolizumab significantly improved pathological responses without increasing toxicity or side effects. Meanwhile, we additionally reviewed the advanced pathological mechanisms underlying the combination of immune checkpoint blockade and NAC. These mechanisms encompass several key processes, including immunogenic cell death, increased immunogenicity of cancer cells, anti-angiogenic effects, and myeloid immunosuppressive cells. Consequently, the approach facilitates the transformation of tumors from a non-inflammatory state to an inflammatory state, thereby enhancing immune response rates.