Hello, my mom is a 67 y/o female with a rapidly growing left SCC tongue tumor that is pd-L1 + and > 4cm. From the PET, they see 1 likely node involved, but the tumor crosses the midline of her tongue so they would treat both sides. She also has other health issues including past significant arterial complete blockages that have been repaired at Cleveland Clinic 2 years ago. She has kidney disease that is moderate related to this.

We've had 2 major medical centers in Chicago, IL review her case. 1 is suggesting immunotherapy then surgery, then radiation and likely chemo. The second, University of Chicago, is suggesting chemotherapy and immunotherapy immediately, then likely surgery + radiation. I've been looking up the trials and there seems to be good support for immunotherapy prior to surgery, but the chemo before therapy seems to be reserved for inoperable tumors or recurrent cancer, neither of which is her case. U of C is a pioneer in tongue sparing approaches but I know its not the typical care. Im her advocate and ultimately she will look to me to help her decide. I'm so scared to make the wrong choice. Has anyone had chemo and immunotherapy as a neoadjuvant therapy, then a subtotal glossectomy and radiation? Or aware of any data to support it? Thank you.