We use CT and ultrasound to reach tumors in challenging places in the head and neck. We break the tumor open with short electrical pulses through a needle, not heat, which can be used safely in tumors against arteries or the airway, then inject immunotherapy into it. For head and neck cancer that heat cannot reach, or that has outlasted the drugs.
Complete a short, three-step form to begin your admissions process. One of our patient consultants will contact you to explain the process and guide you through the next steps.
When head and neck cancer comes back or spreads after immunotherapy, few options remain. Under image guidance, a WCI physician places a thin needle into the tumor and breaks its cells open with electrical pulses rather than heat, because these tumors can sit against the carotid, airway and nerves. That releases the tumor's own antigens: the markers the immune system uses to recognize cancer. In the same session, immune drugs go into that exact spot. It works alongside your current treatment, not in place of it.
The immune drugs placed in the tumor teach the immune system to recognize this cancer, the way a vaccine does. You teach the immune system in one spot, and it goes after the same cancer in the rest of the body.
The treated tumor is the source of the vaccine, and it keeps supplying it. It is not one exposure and done. Every round of tumor cells the immune system destroys exposes new antigens, and those restart the cycle, so the response keeps spreading: broader, throughout the body, and with memory. It turns a “cold” tumor, one the immune system ignores, “hot”.
Card 06 leads back to card 02. Doctors call the widening response epitope spreading.
Ablation means treating a tumor through a needle, where it sits, instead of cutting it out. A hot probe near the carotid artery, the jugular vein, a nerve or the airway is dangerous. Pulsed electric fields break tumor cells open without heat, so we can treat tumors where heat-based ablation is ruled out.
HPV causes many throat cancers, and those tumors carry viral proteins the immune system should see. The tumor hides them. Breaking it open releases them, so the immune system finally has something to see, and the drugs we inject into that spot are chosen to push it to act.
Not every session needs the electrical pulses. Some are an injection of immune drugs into the tumor alone, as in the second session of the case below.
The lining of the mouth and throat around a head and neck cancer often carries other small, early patches of abnormal cells. An immune response raised at one tumor acts against those too, and against spread elsewhere. The cycle above keeps re-priming that response.
Standard care. Early disease: surgery or radiation. Locally advanced disease: concurrent chemoradiation, with cetuximab in selected cases. Recurrent or metastatic disease: pembrolizumab, alone for a PD-L1 combined positive score of 1 or more or with chemotherapy, is first-line standard care [2]; after progression, cetuximab-based regimens, then single agents, and options narrow. Intravenous (IV) pembrolizumab gives systemic drug exposure.
Ablation alone. Local control. Heat-based ablation is limited in the head and neck because tumors sit against the carotid arteries, jugular veins, cranial nerves and airway.
This approach. Image-guided ablation of the tumor using pulsed electric field (PEF) ablation, a non-thermal method that can be used where heat would injure a vessel, a nerve or the airway; combined in the same session with a multi-agent intratumoral immunotherapy injected into the ablation bed. Injection-only sessions, without ablation, are also used. It is intended for disease that has come back or spread after the standard lines.
Case review. CT or MRI of the head and neck, PET, and biomarker reports (HPV/p16, PD-L1 CPS, NTRK, ERBB2) are read by the Williams Cancer Institute team. Airway status and the tumor's relation to the carotid are assessed from the imaging.
Protocol design. The intratumoral combination is chosen from HPV status, immune profile and prior lines.
Guidance and ablation. Image-guided percutaneous access. PEF ablation in multiple cycles.
Intratumoral immunotherapy. Through the same access, a multi-agent combination is injected into the ablation bed.
Setting and time. About an hour for the procedure under conscious sedation, and about two hours of recovery. Most procedures are outpatient under conscious sedation; general anesthesia or an overnight stay is rarely required.
Follow-up. Imaging at 6 to 8 weeks. Repeat procedures as indicated; the number of treatments is decided with the patient's physician. The home head-and-neck, radiation and medical oncology teams are kept informed throughout.
Agents. The injected immunotherapy is a multi-agent combination. The agents and doses are set per patient by the treating physician.
The immune conversion cycle, in clinical terms. Ablation disrupts the tumor and exposes its full antigen repertoire, not a pre-selected subset. The injected immunotherapy then remodels the tumor microenvironment, priming, recruiting and activating immune cells and releasing the brakes on them. Immune-mediated lysis exposes further antigens, which re-prime the response (epitope spreading), producing a broader, polyclonal, systemic response with memory, converting a cold tumor hot. This is WCI’s stated rationale, in Dr. Goodyear’s framing, borne out in our clinical observations.
Rationale. Many head and neck cancers, especially HPV-positive oropharyngeal cancers, carry viral proteins (E6 and E7) that the immune system can in principle recognize; the tumor masks them. HPV-negative disease is colder. WCI's rationale is that ablation exposes the tumor's antigens and that the injected agents amplify immune recognition of them at the site, and that because the surrounding mucosa often harbors other early lesions (field cancerization), an immune response raised at one lesion may act against lesions that share its antigens. Both are seen in our clinical observations.
Evidence, and its limits. In mice with colorectal tumors and no ablation, anti-CTLA-4 injected into a tumor reached about 14 times the day-7 level of IV dosing in that tumor; the untreated tumor received no more than with IV dosing, and half the dose reached the blood within an hour [1]. That is mouse data in a colorectal model, not head and neck; it does not test ablation or show a distant-site effect. KEYNOTE-048 established pembrolizumab, alone or with chemotherapy, as first-line standard care in recurrent or metastatic disease [2]. The one recorded case under 'What the records show' is a single documented course, not a series. There is no published WCI series in head and neck cancer and no randomized trial of this combination.
One patient's course from our records, with the scans exactly as recorded. Not every patient will have the same result.
Primary squamous cell carcinoma of the right maxillary sinus.
September 2024 · Durable complete response on MRI, Month 14
Fourteen months after the last session, the MRI showed no evidence of disease.
A large tumor in the sinus behind the cheek, reaching toward the eye socket, with no spread to distant organs. A needle broke the tumor open with electrical pulses and immunotherapy was injected into it; four weeks later there was one injection-only session. An MRI about 14 months after the last session showed no evidence of disease.
A newly found sinus cancer, treated where it sat.
An MRI of the head and neck about 14 months after the last treatment showed no evidence of disease and no recurrence. No later scans have been done: the patient reports feeling well and has declined further imaging (treating physician).
Durable complete response. The patient was without evidence of disease on MRI 14 months after the last treatment.
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Where your cancer is, and what it has already been given, decides where we fit. Find the card closest to what you have been told. If you are unsure, send your records: a physician decides case by case, from your actual records.
Usually a tumor a needle can reach safely, plus one of these:
Each case is individually evaluated by the Williams Cancer Institute team.
After completing our admissions form, one of our Patient Consultants will contact you to explain the process and guide you through the next steps. Our admissions process is free of charge, including the review of your medical information and, if our medical team determines that you are a candidate, a video consultation. Treatments are generally not covered by health insurance, and WCI does not bill insurance companies.
One of our Patient Consultants will contact you to explain the admissions process, answer your general questions, and guide you through the next steps.
Your Patient Consultant will guide you on the required medical records and imaging studies, as well as how to submit them so our medical team can evaluate your case.
Once the necessary information has been received, our medical team will review your case to determine whether you may be a candidate for our treatments. If necessary, the medical team may request additional studies or information before making a decision.
If our medical team determines that you are a candidate, we will coordinate a complimentary Zoom consultation with one of our physicians. During this consultation, you will be able to discuss your case, address your medical questions, and learn about the treatment approach indicated for you.
Following your medical consultation, you will receive a personalized treatment plan that includes the corresponding costs. If you decide to proceed, the next steps will be coordinated to schedule your treatment.
Most treatments take place in Los Cabos, Mexico; in some cases our medical team may schedule a procedure in Mexico City. Rebyota is given only at our Beverly Hills, California location.
Your physician confirms the details for your case.
The airway is protected during the procedure, which may mean general anesthesia. Your physician goes through the risks for your case before anything is decided.
Dr. Jason Williams is a board-certified radiologist who has spent his career putting needles into tumors under imaging. His first patent, in 2003, covered ablation combined with immunotherapy injected into the tumor. A physician since 2000, he opened his first ablation center in 2004 and completed his residency in 2007. He also co-founded Syncromune, whose separate investigational drug SV-102 holds FDA Fast Track status. His tumor board reviews every case.
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Most of our treatments are performed in Los Cabos, Mexico, in a private hospital setting.
Other treatment locations. In some cases our medical team may schedule a procedure in Mexico City. Rebyota is given only at our Beverly Hills, California location.
Accounts Williams Cancer Institute publishes, shared with each patient's permission. They span different cancers. Individual results vary and are not guaranteed.
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Read the full account →Complete our admissions form to get started. One of our Patient Consultants will contact you to explain the process and guide you through the next steps, including the medical information and imaging studies required for our medical team to evaluate your case.
