The value of immunotherapy in head and neck cancer

ABSTRACT

Introduction: Head and neck squamous cell carcinomas (HNSCC) previously had limited treatment options once patients had progressed on systemic chemotherapy. With recent advances, immunotherapy now plays an important role in the treatment of advanced disease with improved outcomes as compared to cytotoxic chemotherapy.

Areas covered: This article reviews the effects of the immune system and how it influences the development and response to HNSCC therapy. We additionally provide a summary of immunotherapy treatments available as well as their applicable clinical trials that led to their approval.

Expert Commentary: The challenges that need to be addressed in order to maximize the benefits of immunotherapy in HNSCC are the selection criteria for immune checkpoint inhibitors and the optimization of combination regimens of immunotherapeutics or chemo-immunotherapy. Furthermore, there remains to be a lack of knowledge in how to incorporate molecular biomarkers as predictors of response to HNSCC immunotherapy.

KEYWORDS:

• Head and neck cancer
• squamous cell cancer
• PD-1
• PD-L1
• HPV
• P16
• Checkpoint inhibitors

Article Highlights

• Immunotherapy has an important role in HNSCC with several agents recently approved and others in development.

• There are several different immunotherapic approaches in HNSCC due to the fact that there are several types of tumor under that category.

• Selection criteria for immune checkpoint blockade remains unclear

• How choosing how to combine different immunotherapies with or without chemotherapy will impact the efficacy of these drugs.

• The search for biomarkers for immunotherapy in HNSCC. Thus far, PD-L1 and TMB has opened some horizons

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.