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Scientific Oral Presentation

Head and Neck Surgery

Immunologic and Metabolic Predictors of Neoadjuvant Immunotherapy Response in OCSCC

Monday, October 19, 2026
11:24 AM - 11:30 AM PT
Location: West Exhibit Hall A, Learning Zone 3

    Presenting Author(s)

  • Wyatt Wofford, BS

    MSTP (MD/PhD) Candidate
    Medical University of South Carolina
    Charleston, South Carolina, United States

    • Co-Author(s)

  • MM

    Mary E. Moore, BS

    MD PhD student
    Medical University of South Carolina
    Charleston, South Carolina, United States

  • AO

    Anneliese Opran, BS

    Medical Student
    University of Michigan Medicine, United States

  • DA

    Dauren Adilbay, MD PhD

    Assistant Professor
    Medical University South Carolina, South Carolina, United States

  • PY

    Pratyusha Yalamanchi, MD MBA

    Clinical Assistant Professor
    University of Michigan, United States

    • Senior Author(s)

  • Alexandra E. Kejner, MD, FACS

    Associate Professor Head&Neck Surgical Oncology, Microvascular Reconstruction
    Medical University of South Carolina
    Charleston, South Carolina, United States

Introduction: Neoadjuvant immunotherapy (IO) is increasingly used in locally advanced oral cavity squamous cell carcinoma (OCSCC), yet predicting response remains challenging. The combined positivity score (CPS) is commonly used but imperfect. In other types of cancer, readily available markers such as immune cell counts and metabolic parameters have shown predictive value for IO response. This study evaluates whether routine blood tests (CBC w/ diff and BMP) predict response to neoadjuvant IO in OCSCC.

Methods: We performed an IRB-approved, retrospective review of 14 patients with locally advanced OCSCC treated with standardized neoadjuvant IO followed by surgery at two academic institutions. Pathologic response was categorized as complete (CR, n=2), partial (PR, n=7), or non-responder (NR, n=5). Lab work (CBC w/ diff and BMP) was obtained before (PRE) and during (ON) IO infusion. Quantitative comparisons were made by response group, and correlations between lab values and CPS were assessed. For statistical purposes, CR and PR were pooled (CR/PR) for comparison against NR.

Results: In the PRE setting, CR/PR demonstrated higher lymphocytes (1.85 vs 1.57, p=0.355) and lower neutrophils (4.93 vs 8.90, p=0.002), lymphocyte:neutrophil ratio (3.08 vs 4.78, p=0.215), platelets (266 vs 353, p=0.128), and platelet:lymphocyte ratio (159 vs 242, p=0.156). Similar trends were observed in the “ON” setting. Patient-specific response to IO (ON minus PRE) showed that CR/PR patients more effectively expand lymphocytes (0.73 vs -0.25, p=0.221) and maintain HgB (0.08 vs -0.40, p=0.168). At baseline, CPS correlated most strongly with basophils (r=-0.492, p=0.074) and monocytes (r=-0.464, p=0.095).

Conclusions: Routine CBC- and BMP-derived markers differed by pathological response to neoadjuvant IO in OCSCC, with CR and PR patients demonstrating distinct profiles compared to NR patients. These readily available biomarkers may complement CPS to improve IO response prediction, though validation in larger cohorts is needed.