Case report demonstrates intraoperative micro-PET/CT detection of complete response after neoadjuvant pembrolizumab in laryngeal cancer, suggesting novel surgical margin assessment utility.
Background Neoadjuvant immunotherapy is an emerging treatment for patients with head and neck cancer. Given the heterogeneity of response, novel methods of intraoperative tumor and margin assessment warrant investigation. Methods A 55‐year‐old male presented with a cT3N2c supraglottic squamous cell carcinoma with a combined positive score of 5. The patient received 2 cycles of neoadjuvant pembrolizumab prior to laryngectomy. The specimen underwent intraoperative micro‐positron emission tomography/computed tomography (micro‐PET/CT) imaging. Results Final pathology demonstrated a pathologic complete response (pCR). On pre‐treatment whole body PET/CT, maximum standardized uptake value (SUV max ) was 21.8 in the tumor and 10.7 (~50%) at the tracheostomy site. Intraoperative micro‐PET/CT showed residual uptake in the tumor region (SUV max 16.1) and tracheostomy site (SUV max 16.9). Conclusion In this case report of pCR, intraoperative micro‐PET/CT demonstrated similar avidity at the primary tumor site compared to the tracheostomy site, highlighting the potential utility of this novel imaging approach in patients receiving neoadjuvant immunotherapy.
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Austerlitz et al. (2026) studied this question.
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