Impact of New Adjuvant Medical Treatments on Surgical Management in Head and Neck Tumors
Seance of wednesday 20 may 2026 (L'Académie reçoit la Société Francophone de Chirurgie Oncologique)
DOI number : 10.26299/8vd9-2y77/emem.2026.21.07
Abstract
The evolution of medical treatments, particularly the rise of immunotherapy and targeted therapies, is transforming the management of head and neck cancers. Historically dominated by radical surgery, therapeutic strategies are now shifting toward multimodal approaches combining surgery, radiotherapy, chemotherapy, and immunotherapy.
Several recent clinical trials have shown promising results. The KEYNOTE-689 study demonstrated a significant improvement in event-free survival with perioperative pembrolizumab in patients with resectable locally advanced squamous cell carcinoma, without compromising surgical feasibility. Similarly, the NIVOPOSTOP trial showed a benefit from adding nivolumab to adjuvant chemoradiotherapy after surgery, resulting in improved disease-free survival.
In BRAFV600E-mutated anaplastic thyroid cancers, the neoadjuvant combination of dabrafenib, trametinib, and pembrolizumab increased resectability rates and improved overall survival. Other neoadjuvant immunochemotherapy strategies have also demonstrated encouraging major pathological response rates.
These advances pave the way for a redefinition of surgical indications, response-guided surgical de-escalation, and increasing personalization of treatment strategies through biomarker-based selection.
Several recent clinical trials have shown promising results. The KEYNOTE-689 study demonstrated a significant improvement in event-free survival with perioperative pembrolizumab in patients with resectable locally advanced squamous cell carcinoma, without compromising surgical feasibility. Similarly, the NIVOPOSTOP trial showed a benefit from adding nivolumab to adjuvant chemoradiotherapy after surgery, resulting in improved disease-free survival.
In BRAFV600E-mutated anaplastic thyroid cancers, the neoadjuvant combination of dabrafenib, trametinib, and pembrolizumab increased resectability rates and improved overall survival. Other neoadjuvant immunochemotherapy strategies have also demonstrated encouraging major pathological response rates.
These advances pave the way for a redefinition of surgical indications, response-guided surgical de-escalation, and increasing personalization of treatment strategies through biomarker-based selection.