Prior to the introduction of immunotherapy, very few options existed for heavily pretreated patients with recurrent and metastatic head and neck squamous cell carcinoma. While several targets for the therapy have been identified, a number of important issues are still being investigated.

In an educational presentation at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting, presenters discussed the current state of immunotherapy research and advances in treatment of this patient population. They examined the response dynamics, efficacy, safety, and tolerability of several checkpoint inhibitors, and reviewed several ongoing studies.1

They focused on 2 checkpoint inhibitory mechanisms in particular: the CTLA-4 and PD/PDL1 pathways, which function at initial and later stages of the tumor immune response. A number of clinical trials have investigated the inhibition of these mechanisms both individually and jointly, as well as in combination with other therapies.

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“There are a lot of ongoing studies that are looking at a combination of targeted therapy and immune therapy,” said article coauthor Nooshin Hashemi Sadraei, MD, of the University of Cincinnati in Ohio, in an interview with Cancer Therapy Advisor. “We know for a fact that when you add targeted therapy you can have an added or synergistic effect with immune therapy, depending on what setting you’re looking at.” 

The article discussed the ongoing search for reliable biomarkers to identify subgroups that will benefit from immunotherapy. Potential candidates include gene expression signatures of the “T-cell inflamed phenotype,” which has been identified as a predictor of clinical benefit from anti-PD1 for patients with head and neck cancer.