Ezra Cohen, MD, associate director and professor of medicine at the Moores Cancer Center, UC San Diego, La Jolla, Calif., discusses the promise of immune-based strategies in head and neck cancer and their potential role in the treatment paradigm.
“We’re just beginning to learn how to integrate immunotherapy with curative intent therapy — with radiation, with chemotherapy — in the context of patients who have surgery.”
He provides a “framework” for the populations clinicians might be managing, detailing current approaches for local or locally-advanced disease as well as for recurrent and metastatic forms, then delves into data on various immune strategies.
Cohen highlights the “remarkably” improved response rates seen specifically with single-agent PD-1 inhibitor pembrolizumab (Keytruda, Merck) in squamous cell carcinoma of the head and neck as well as a general response durability that suggests “immunotherapy may change the landscape in the very near term.”
He notes the field still lacks the phase 3 findings needed to shift standard practice but points to highly-anticipated data from ongoing research evaluating PD-1 and PD-L1 antibodies as monotherapies or as part of combination regimens.
Cohen touches on encouraging early data with PD-L1 and CTLA-4 antibodies combined in managing squamous cell carcinoma of the lung, which the field believes will “carry forward” to head and neck, as well as other “interesting combinations” involving IDO inhibitors or OX40 and 4-1BB antibodies.
“[There’s] a lot of excitement about immunotherapy in head and neck cancer, a lot of things to keep our eye on.”