A phase II study for PREServing TOngue with Neoadjuvant chemoimmunotherapy and chemoradiation in advanced tongue cancers: PRESTO study

Advanced tongue cancers are treated with surgery (which involves removal of the affected part of tongue) and removal of lymph nodes from the neck. This is followed by 6-7 weeks of radiation therapy (RT) (a form of cancer treatment which involves killing of cancer cells with high energy X-rays). Chemotherapy (medicines used to kill cancers cells) can be combined with RT to increase the effect of RT. This is called as CTRT.

 Removal of large part of tongue followed by RT/ CTRT leads to problems which impact the day to day life of many patients after treatment. These include swallowing difficulty, unclear speech, loss of taste etc.

 Immunotherapy is a relatively new form of cancer treatment which enhances the capability of body to destroy cancer cells. It is available as a medicine similar to chemotherapy

 In this study we are combining chemotherapy, immunotherapy and RT in an attempt to preserve your tongue. We will first give patients with advanced tongue cancer a combination of chemotherapy and immunotherapy. After this in patients a good amount of reduction in the cancer, we will offer these patients CTRT. Hence, in these patient’s surgery will be omitted.

 We believe that with this approach, we will be able to preserve the tongue in a significant number of tongue cancer patients who otherwise would have required removal of large parts of their tongue. We also believe that with this approach patients will be able to have a much better quality of life after treatment without impacting the cancer control rates.