NeoLOCUS Trial

Rodrigo Arrangoiz MS, MD, FACS, FSSO

– Borderline resectable oral cavity cancer is a surgical dilemma
Can chemo-immunotherapy increase operability?

A new Phase II trial suggests yes

🧪 NeoLOCUS trial (Lancet Regional Health SE Asia)

Regimen:
Carboplatin + nab-paclitaxel + low-dose nivolumab
•oral metronomic therapy (methotrexate + celecoxib + erlotinib)

🎯 Population
Borderline resectable OSCC
n = 34

📊 Key results

  • ORR: 66.6%
  • R0 resection after 2 cycles: 75.7%
  • Overall surgical conversion: 90.3%
  • Major pathological response: 41%
  • pCR: 13.8%

🧬 Interesting biology
Good responders showed reduction in FOXP3+ Tregs, suggesting immune-microenvironment modulation.

⚠️ Safety
Grade ≥3 toxicity: 14.7%
No treatment-related deaths.

💡 Why this matters

Borderline OSCC often fails surgery after standard NACT.
This low-dose IO + metronomic + chemo strategy may offer an affordable outpatient approach in LMIC settings.

But this is single-arm Phase II → randomized validation needed.

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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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