Trends in the Use of Neoadjuvant Systemic Therapy for Head and Neck Squamous Cell Carcinoma

What are the trends in neoadjuvant systemic therapy use in head and neck squamous cell carcinoma (HNSCC)?In this cohort study of 312 748 patients with HNSCC undergoing definitive surgery from 2004 to 2022, 0.6% received neoadjuvant systemic therapy. Neoadjuvant immunotherapy use significantly increased over time, whereas neoadjuvant chemotherapy use decreased, and neoadjuvant immunotherapy recipients were more likely to have private insurance and stage IV disease and less likely to be of Black race.Findings from this study suggest that increasing neoadjuvant immunotherapy use reflects evolving treatment practices in HNSCC and highlights disparities, underscoring the need to align emerging therapies with health care access and disease severity.

Corresponding Author: Kevin J. Contrera, MD, MPH, Department of Otolaryngology–Head and Neck Surgery, University of Pittsburgh Medical Center, 203 Lothrop St, Pittsburgh, PA 15213 (contrerakj@upmc.edu).

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