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Copenhagen, Denmark
Onsite/Online

ESTRO 2022

Session Item

Head and neck
Poster (digital)
Clinical
Predictive Factors for Response to Neoadjuvant Chemoradiotherapy for Oral Cavity Cancer
Jens von der Grün, Switzerland
PO-1113

Abstract

Predictive Factors for Response to Neoadjuvant Chemoradiotherapy for Oral Cavity Cancer
Authors:

Jens von der Grün1,2, Ria Winkelmann3, Iris Burck4, Franz Rödel1,2, Andreas Weigert5, Christian Brandts6,2, Christian Issing7, Philipp Thönissen8, Daniel Martin1,2, Claus Rödel9,2, Shahram Ghanaati8, Panagiotis Balermpas9,10

1University Hospital Frankfurt, Department of Radiotherapy and Oncology, Frankfurt, Germany; 2German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany; 3University Hospital Frankfurt, Dr. Senckenbergisches Institute of Pathology, Frankfurt, Germany; 4University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt, Germany; 5University of Frankfurt, Institute of Biochemistry I, Frankfurt, Germany; 6University Hospital Frankfurt, Department of Medicine, Hematology/Oncology, Frankfurt, Germany; 7University Hospital Frankfurt, Department of Otorhinolaryngology, Frankfurt, Germany; 8University Hospital Frankfurt, Department of Oral, Maxillofacial and Facial Plastic Surgery, Frankfurt, Germany; 9University Hospital Frankfurt, Department of Radiotherapy and Oncology , Frankfurt, Germany; 10University Hospital Zurich, Department of Radiation Oncology, Zurich, Switzerland

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Purpose or Objective

To study neoadjuvant chemoradiotherapy (nCRT) and potential predictive factors for response to therapy in locally advanced oral cavity cancer (LA-OCC).

Material and Methods

The INVERT trial is an ongoing single-center, prospective trial. Operable patients with stage III-IVA squamous cell carcinomas of the oral cavity or oropharynx were eligible and received nCRT consisting of 60Gy with concomitant cisplatin and 5-fluorouracil administration. Surgery was conducted 6-8 weeks following nCRT. Explorative, multiplex immunohistochemistry (IHC) was performed on pre-treatment tumor tissue specimens and diffusion-weighted magnetic resonance imaging (DW-MRI) was performed prior, during, and after nCRT in order to identify potential predictive biomarkers. Primary endpoint was pathological complete response (pCR) rate.

Results

Seventeen patients with stage IVA OCC were enrolled and included into this interim analysis. All patients completed nCRT. One patient died from pneumonia ten weeks after nCRT completion. Complete tumor resection (R0) was achieved in 16/17 patients who underwent surgery. pCR rate was 41% in the intention-to-treat population (n=7). Greater changes in the apparent diffusion coefficient signal intensities between MRI at day 15 of nCRT and before surgery were associated with better response (p=0.022). Higher abundances of PD1+ cytotoxic T-cells (p=0.012), PD1+ macrophages (p=0.046), and cancer-associated fibroblasts (CAFs, p=0.036) were associated with incomplete response to nCRT.

Conclusion

nCRT for LA-OCC followed by radical surgery is feasible and shows high response rates. Larger patient cohorts from randomized, controlled trials are needed to further investigate nCRT and potential predictive biomarkers such as changes in DW-MRI signal intensities, tumor infiltrating immune cells, and CAFs.