Abstract 4522: Old dog, new tricks: The role of capecitabine in HPV-negative head and neck cancer
Bibliographic record
Abstract
Abstract Objective: Treatment for HPV-negative head and neck squamous cell carcinoma (HNSCC) has seen little innovation, particularly in advanced-stage disease, where outcomes remain suboptimal. The public healthcare system's delays in access to care can exacerbate this issue, allowing tumors to progress prior to treatment initiation. This study explores the use of capecitabine, an oral chemotherapy agent, in both preoperative and recurrent settings for HPV-negative HNSCC. Study Design: We conducted a prospective cohort study of patients with stage III/IV HPV-negative HNSCC at two academic centers in Montreal, Canada. The study evaluated clinical and pathological responses in patients receiving capecitabine in a preoperative setting, with radiological and clinical outcomes assessed for those with unresectable recurrent disease. Results: Among the 34 patients included in the study (23 oral cavity, 1 oropharynx, 5 skin, 5 larynx), 31 received capecitabine preoperatively, while 3 had recurrent, unresectable disease. Of the 31 patients undergoing surgery, 16 exhibited clinical tumor reduction, 13 remained stable, and 2 experienced tumor growth. Pathological responses were observed in 15 patients, including 1 complete response (skin) and 6 major responses based on the modified Ryan criteria. Two non-responders developed recurrences within one year. The mean follow-up for surgical patients was 6 months. In the non-surgical cohort, all three patients showed reduced pain and radiological improvements, with a mean follow-up of 8 months. No significant toxicity related to capecitabine was reported. Conclusion: Capecitabine, used either in a preoperative window of opportunity or in the recurrent setting, demonstrated measurable clinical and pathological responses in patients with HPV-negative HNSCC. Given its efficacy and low toxicity, further investigation of this oral agent is warranted, particularly in resource-constrained settings where timely access to treatment may be a challenge. Citation Format: Marco Antonio Mascarella, Nisha Suarez, Keith Richardson, Alex Mlynarek, Michael Hier, Nader Sadeghi, Khalil Sultanem, Derin Caglar, Marc Pusztaszeri, Livia Florianova, Nathaniel Bouganim, Khashayar Esfahani. Old dog, new tricks: The role of capecitabine in HPV-negative head and neck cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4522.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".