MD Anderson Trial Finds Local Nivolumab Injections Eliminate Need for Surgery in 90% of Oral Precancer Patients

MD Anderson study shows direct nivolumab injections shrink oral lesions by 60%, sparing 90% of patients from invasive mouth surgery.

By: AXL Media

Published: Apr 22, 2026, 4:54 AM EDT

Source: Information for this report was sourced from University of Texas M. D. Anderson Cancer Center

A Shift from Ablation to Immune Interception

For patients with precancerous oral lesions (oral dysplasia), the traditional "standard of care" has been a grim cycle of surgical removal or ablation. Because these lesions often recur, many patients undergo multiple surgeries that can eventually remove significant portions of the tongue and mouth, permanently impacting the ability to speak, swallow, and eat. However, new research led by Dr. Moran Amit at MD Anderson suggests that the immune system can be "trained" to eliminate these "bad players" before they turn into invasive cancer. By injecting the immunotherapy drug nivolumab directly into the affected tissue, researchers achieved a dramatic reduction in lesion size without the trauma of a scalpel.

The Power of Low-Dose, Localized Delivery

The Phase I trial enrolled 29 patients with various grades of oral dysplasia. The innovation lay in the delivery method: rather than a full systemic dose via IV—which can cause significant side effects—patients received "intralesional" injections. This dose represented only 2% to 4% of a standard systemic dose. Because the drug was delivered with 100% bioavailability directly to the target, it bypassed the bloodstream, resulting in negligible systemic toxicity. After four weekly cycles, the results were striking: 85% of patients saw their lesions shrink, with an average reduction of 60% in size.

Pathologic Responses and Surgical Prevention

The clinical outcomes suggest that local immunotherapy can fundamentally change the biology of precancer. Key highlights from the trial data include: