Complete Pathologic Response to Neoadjuvant Pembrolizumab Captured on Intraoperative PET/CT: A Case Report and Exploratory Analysis.

Authors

Joaquin Austerlitz, Andreja Radevic, Ashtyn McAdoo, Kyrionna Golliday, Cassie Pan, Annie Moroco, Spencer Roark, Michael C Topf

Published in

Head & neck. Sep 03, 2026. Epub Sep 03, 2026.

Abstract

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.
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.
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).
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.

PMID:
42693001
Bibliographic data and abstract were imported from PubMed on 04 Sep 2026.

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