Immunotherapy for Treatment of Squamous Cell Carcinoma of the Head and Neck
Publication Date: July 15, 2019
Key Points
Key Points
Squamous cell carcinoma of the head and neck (HNSCC) is the 9th leading cancer by incidence worldwide and constitutes 90% of all head and neck cancers.
HNSCC is a biologically diverse and genomically heterogeneous disease that arises from the squamous mucosal lining of the upper aerodigestive tract.
In addition to traditional risk factors including smoking and alcohol consumption, over the last two to three decades it has become apparent that the human papillomavirus (HPV) and Epstein Barr Virus (EBV) are associated with development of squamous cell carcinoma of the oropharynx and nasopharynx, respectively.
Despite advances in surgery and radiotherapy, five-year survival rates for patients (excluding EBV-related nasopharyngeal) with HNSCC across all stages remain 40-50% for tumors caused by the traditional carcinogens smoking and alcohol consumption.
Between 2016 and 2019, the US Food and Drug Administration (FDA) approved two immunotherapeutic agents, the anti-programmed cell death protein (PD-1) monoclonal antibodies, nivolumab (Opdivo, Bristol-Myers Squibb) and pembrolizumab (Keytruda, Merck), for the treatment of patients with recurrent/metastatic (R/M) HNSCC.
/PD-L1 ICIs can block suppressive signaling of T cell immunological responses through the PD-1/PD-L1 pathway and enhance antitumor immune activity.
HNSCC is a biologically diverse and genomically heterogeneous disease that arises from the squamous mucosal lining of the upper aerodigestive tract.
In addition to traditional risk factors including smoking and alcohol consumption, over the last two to three decades it has become apparent that the human papillomavirus (HPV) and Epstein Barr Virus (EBV) are associated with development of squamous cell carcinoma of the oropharynx and nasopharynx, respectively.
Despite advances in surgery and radiotherapy, five-year survival rates for patients (excluding EBV-related nasopharyngeal) with HNSCC across all stages remain 40-50% for tumors caused by the traditional carcinogens smoking and alcohol consumption.
Between 2016 and 2019, the US Food and Drug Administration (FDA) approved two immunotherapeutic agents, the anti-programmed cell death protein (PD-1) monoclonal antibodies, nivolumab (Opdivo, Bristol-Myers Squibb) and pembrolizumab (Keytruda, Merck), for the treatment of patients with recurrent/metastatic (R/M) HNSCC.
/PD-L1 ICIs can block suppressive signaling of T cell immunological responses through the PD-1/PD-L1 pathway and enhance antitumor immune activity.
Immunotherapy for Head and Neck SCC
...Immunotherapy...
Table 1. Key clinical immunotherapy recommendations for treatment of patients with HNC*
...Table 1. Key clin...
Evaluation
...Evaluat...
Indications Do NOT...
...Biomarkers The subcom...
...HPV status HPV status (based on p16 overexpre...
Treatment
...Treat...
...Combination systemic therapy Since...
...egrating PD-1 inhibitors First-line:...
...Rare head and neck cancer subt...
Treatment Response
...T...
...Evalutation and Managemen...
...Immune-related Adverse E...
...ity of life and Patient Engagement...
TEXT
...Consensus: >50%...
Figure 1. First-line Treatment Algorithm for R/M HNSCC Patients
.... First-line Treatment Algorithm for R/M HNSCC P...