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News
For patients with locally advanced head and neck squamous cell carcinoma (HNSCC) who respond well to pre-surgery immunochemotherapy, reducing the extent of surgery may lead to better outcomes. The phase 2 REMATCH trial found that patients who achieved at least 50% tumor shrinkage and underwent reduced-volume surgery had a 2-year disease-free survival rate of 90% — and 100% laryngeal preservation.
Traditional treatment for locally advanced head and neck squamous cell carcinoma (HNSCC) — radical surgery followed by radiation and chemotherapy — is notoriously tough on patients, often impairing swallowing, speech, and appearance. But a new phase 2 trial called REMATCH suggests a more tailored approach may be on the horizon.
The trial enrolled 50 adults with resectable, HPV-negative locally advanced HNSCC. All received three cycles of neoadjuvant immunochemotherapy (penpulimab, albumin-bound paclitaxel, and cisplatin). Patients who achieved ≥50% primary tumor regression underwent reduced-volume surgery (RVS), while non-responders had standard-volume surgery (SVS). Everyone received adjuvant radiotherapy and nine cycles of maintenance immunotherapy afterward. Notably, all 39 patients with laryngeal/hypopharyngeal cancer in the RVS group preserved their laryngeal function — including 22 who weren't initially eligible for preservation.
By the Numbers:
Why it matters: This is the first prospective trial of response-adapted surgical de-escalation after neoadjuvant immunochemotherapy in head and neck cancer. If validated in a phase 3 randomized trial, this strategy could spare patients from function-impairing surgery — without compromising cancer control.
