Otolaryngology (ENT)

Neoadjuvant chemoimmunotherapy improves pCR and survival in stage III–IVA oral SCC

In 475 stage III–IVA oral SCC patients, neoadjuvant immunochemotherapy (NAIC) produced markedly higher pCR than immunotherapy–cetuximab or chemotherapy alone. pCR was 30.2% with NAIC vs 13.0% with immunotherapy–cetuximab and 7.3% with chemotherapy, with higher major pathologic response and objective response rates. Three-year event-free survival was 73.6% with NAIC vs 56.5% and 46.3%, and 3-year OS was also significantly higher. R0 resection was nearly universal with NAIC, without treatment-related deaths, though hypothyroidism was more frequent. Efficacy was more strongly associated with PD-L1 expression than with the number of neoadjuvant cycles, supporting biomarker-driven selection. 1

Tislelizumab plus chemotherapy achieves high MPR and enables de-escalated surgery in LA oral/oropharyngeal SCC

This single-arm phase II trial treated 82 stage III–IV oral or oropharyngeal SCC patients with two cycles of tislelizumab, nab-paclitaxel, and cisplatin before surgery. Among 73 resected patients, the major pathologic response rate was 60.3% and pathologic complete response was 34.2%. Radiologic objective response was 67.9%, enabling de-escalated primary surgery in 40 patients and avoiding several extensive resections. At 24-month median follow-up, 2-year OS was 84.4% and event-free survival 76.7%, with grade 3–4 neoadjuvant adverse events in 13.4%. 2

Definitive radiotherapy as a rhinectomy-sparing option for nasal cavity cancers

This cohort study examined definitive radiotherapy with or without chemotherapy for nasal cavity cancer in patients declining or unsuitable for rhinectomy. Instead of rhinectomy plus adjuvant therapy, patients received organ-preserving definitive radiotherapy–based treatment. The study focused on oncologic outcomes and feasibility of nasal organ preservation in this setting. Results support definitive radiotherapy as a reasonable rhinectomy-sparing strategy for selected nasal cavity cancers, with careful patient selection. 3

Genome sequencing increases diagnostic yield in nonsyndromic bilateral SNHL with single GJB2 variants

This retrospective study evaluated 23 patients with bilateral SNHL and a single pathogenic GJB2 variant using stepwise genetic testing. Targeted GJB2 resequencing identified biallelic pathogenic variants in three individuals, providing a definitive diagnosis. Exome sequencing gave definitive or likely diagnoses in five of the remaining 20 patients, with two additional inconclusive cases. Genome sequencing of 15 undiagnosed cases yielded diagnoses in three, detecting deletions in LOXHD1, STRC, and an upstream GJB2 regulatory region. Overall, 48% of patients received a diagnosis, and genome sequencing captured all identified pathogenic variants, including CNVs missed earlier. 4