Most patients with head and neck squamous cell cancer (HNSCC) will present with advanced disease characterized by poor prognosis and limited treatment options. Our growing understanding of the complex crosstalk between tumor cells and the immune system has facilitated the development of promising therapies targeting immune checkpoints, such as programmed death 1 and the cytotoxic T-lymphocyte antigen 4, which are producing considerable clinical responses. However, HNSCC tissues use diverse strategies to avoid immunosurveillance, thus limiting our ability to fully harness the immune system to achieve consistent and durable antitumor activity. This may be counteracted by optimizing the dosing, sequence, and timing of immune checkpoint therapies and by combining these regimens with other modalities such as radiation therapy, cancer vaccines, cytotoxic chemotherapies, and molecularly targeted agents. The present review summarizes the pathophysiological role of immune regulation in HNSCC and provides a concise update on the clinical translation of immune checkpoint therapies in this tumor type.
From the Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Conflicts of Interest and Source of Funding: P.M. has disclosed that he has no significant relationships with, or financial interest in, any commercial companies pertaining to this article. E.M. is a consultant for Nektar Pharmaceuticals and is the principal investigator of clinical trials sponsored by Merck, AstraZeneca, and Bristol-Myers Squibb.
Reprints: Erminia Massarelli, MD, PhD, MS, Department of Thoracic and Head/Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Box 432, Houston, TX 77030. E-mail: email@example.com.