scholarly journals Radiotherapy and Immunotherapy for Head and Neck Cancer: Current Evidence and Challenges

2021 ◽  
Vol 10 ◽  
Author(s):  
Jack M. Qian ◽  
Jonathan D. Schoenfeld
Keyword(s):  
Squamous Cell Carcinoma ◽  
Head And Neck Cancer ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Neck Cancer ◽  
Squamous Cell ◽  
Clinical Evidence ◽  
Locally Advanced ◽  
Neck Squamous Cell Carcinoma ◽  
Current Evidence

Immune checkpoint inhibitors (ICI) have revolutionized cancer treatment over the past decade. However, although the immune landscape suggests a strong rationale for the use of these agents in patients with head and neck squamous cell carcinoma, the available clinical evidence indicates that most patients currently do not respond to ICI monotherapy. Radiotherapy is a primary treatment modality for many patients with locally advanced head and neck cancer. While ionizing radiation traditionally has been thought to act in a purely cytotoxic fashion, a growing body of preclinical studies have demonstrated additional profound immunomodulatory effects. Consequently, there has been a surge of interest in the potential synergy between radiotherapy and immunotherapy, both the potential for radiotherapy to augment the systemic anti-tumor immune response and the potential for immunotherapy to improve in-field tumor response to radiation. In this review, we summarize the current preclinical and clinical evidence for radioimmunotherapy, with a particular focus on studies directly relevant to head and neck squamous cell carcinoma, as well as existing challenges and future directions for this emerging field.

scholarly journals Oral health and risk for head and neck squamous cell carcinoma: the Carolina Head and Neck Cancer Study

2010 ◽  
Vol 21 (4) ◽  
pp. 567-575 ◽  
Author(s):  
Kimon Divaris ◽  
Andrew F. Olshan ◽  
Joanna Smith ◽  
Mary E. Bell ◽  
Mark C. Weissler ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Head And Neck Cancer ◽  
Oral Health ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Neck Cancer ◽  
Squamous Cell ◽  
Neck Squamous Cell Carcinoma ◽  
Cancer Study

Sentinel node in head and neck cancer: Use of size criterion to upstage the no neck in head and neck squamous cell carcinoma

Head & Neck ◽  
2007 ◽  
Vol 29 (2) ◽  
pp. 95-103 ◽  
Author(s):  
Lee W. T. Alkureishi ◽  
Gary L. Ross ◽  
D. Gordon MacDonald ◽  
Taimur Shoaib ◽  
Harry Gray ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Head And Neck Cancer ◽  
Sentinel Node ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Neck Cancer ◽  
Squamous Cell ◽  
Neck Squamous Cell Carcinoma ◽  
Size Criterion

scholarly journals Evaluation of Patient-Reported Delays and Affordability-Related Barriers to Care in Head and Neck Cancer

OTO Open ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 2473974X2110653
Author(s):  
Nicholas R. Lenze ◽  
Jeannette T. Bensen ◽  
Laura Farnan ◽  
Siddharth Sheth ◽  
Jose P. Zevallos ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Head And Neck Cancer ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Neck Cancer ◽  
Squamous Cell ◽  
Barriers To Care ◽  
Neck Squamous Cell Carcinoma ◽  
Patient Reported ◽  
Barrier To Care

Objective To examine the prevalence and predictors of patient-reported barriers to care among survivors of head and neck squamous cell carcinoma and the association with health-related quality of life (HRQOL) outcomes. Study Design Retrospective cohort study. Setting Outpatient oncology clinic at an academic tertiary care center. Methods Data were obtained from the UNC Health Registry/Cancer Survivorship Cohort. Barriers to care included self-reported delays in care and inability to obtain needed care due to cost. HRQOL was measured with validated questionnaires: general (PROMIS) and cancer specific (FACT-GP). Results The sample included 202 patients with head and neck squamous cell carcinoma with a mean age of 59.6 years (SD, 10.0). Eighty-two percent were male and 87% were White. Sixty-two patients (31%) reported at least 1 barrier to care. Significant predictors of a barrier to care in unadjusted analysis included age ≤60 years ( P = .007), female sex ( P = .020), being unmarried ( P = .016), being uninsured ( P = .047), and Medicaid insurance ( P = .022). Patients reporting barriers to care had significantly worse physical and mental HRQOL on the PROMIS questionnaires ( P < .001 and P = .002, respectively) and lower cancer-specific HRQOL on the FACT-GP questionnaire ( P < .001), which persisted across physical, social, emotional, and functional domains. There was no difference in 5-year OS (75.3% vs 84.1%, P = .177) or 5-year CSS (81.6% vs 85.4%, P = .542) in patients with and without barriers to care. Conclusion Delay- and affordability-related barriers are common among survivors of head and neck cancer and appear to be associated with significantly worse HRQOL outcomes. Certain sociodemographic groups appear to be more at risk of patient-reported barriers to care.

Should age affect our treatment decisions for head and neck cancer?

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5564-5564
Author(s):  
Estrella M. Carballido ◽  
Jon N Burton ◽  
Miguel Ricardo Pelayo ◽  
Judith C McCaffrey ◽  
Tapan Padhya ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Head And Neck Cancer ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Neck Cancer ◽  
Squamous Cell ◽  
Neck Squamous Cell Carcinoma ◽  
Comprehensive Cancer Center ◽  
Significant Difference

5564 Background: Current opinion suggests elderly patients (pts) with head and neck cancer, those 65 or older, do not tolerate surgery, chemotherapy, or radiation as well as their younger counterparts. If this holds true, elderly pts may not be offered standard treatments to prevent assumed complications. Methods: A retrospective cohort study at our comprehensive cancer center was conducted of newly diagnosed pts with head and neck squamous cell carcinoma to explore differences in treatment-related complications between older and younger groups. We included data from the first 199 eligible pts (99 younger than 65 year old and 100 older than 65) evaluated between April 2009 and June 2010. Results: 79% of pts receiving treatment were male with a mean age of 54.9 and 71.6 years for the younger and older groups respectively. The older group had significantly more comorbidities (p < 0.001). The majority of older pts presented with oral cavity tumors (46%) while the oropharynx was the predominant site in the younger group (45%). 55% of younger and 49% of older pts presented with stage 4 disease across all sites. A total of 51 pts were p16 positive with no statistical differences between the groups. Surgery was the initial treatment for 57% of older pts (p < 0.008) while 46% of younger pts received concurrent chemotherapy and radiation as the primary treatment (p < 0.008). There was no statistically significant difference in surgical or radiation complications between the groups. Although most pts receiving chemotherapy experienced complications, older pts had slightly more (93% vs. 78%; p<0.031). The mean survival was 24.8 months with no statistical difference between groups. Significantly more pts in the older group, at last follow-up, were disease free (p < 0.012). Conclusions: The treatment of elderly pts with head and neck squamous cell carcinoma in our experience was congruent with that of younger pts. Elderly pts did not suffer more complications with surgery or radiation, however chemotherapy produced somewhat more complications in the elderly pts. Elderly pts did display less evidence of disease on follow-up. Age is always a consideration when treating individuals, but should not preclude the curative standard.

Human papillomavirus detection in head and neck squamous cell carcinoma in Turkey.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17538-e17538
Author(s):  
Yasemin Kemal ◽  
Ozgur Kemal ◽  
Mehmet Kefeli ◽  
Ayse Bel ◽  
Nilgun Sahin ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Head And Neck Cancer ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Neck Cancer ◽  
Squamous Cell ◽  
Large Scale ◽  
Neck Squamous Cell Carcinoma ◽  
Smoking History ◽  
Cancer Tissue

e17538 Background: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common type of cancer worldwide. In Turkey, 5538 new cases and 2340 deaths from head and neck cancer are estimated to occur every year. Tobacco and alcohol are the most important etiological risk factors but in the past three decads tobacco usage is decreased and Human Papilloma Virus (HPV) has changed HNSCC epidemiology. Many new reports suggests that almost 25% of all cases of HNSCC are related to HPV. But its prevelans shows a wide variation among different populations.Today in Turkey HPV positivity in HNSCC is currently not known and this retrospective study aimed to to evaluate the HPV infection in our HNSCC patients. Methods: We included 125 HNSCC patients diagnosed and treated in our hospital beween January 2010 and December 2016. Oral cavity, oropharyngeal, laryngeal and hypopharyngeal cancers were included. Nasopharyngeal and salivary gland cancers were exculuded. Head and neck cancer tissue samples fixed using 10% Neutral Buffered Formalin and embedded blocks were used. From an initial evaluation of 125 patients records 77 of the paients blocks could be adequate for the HPV testing. Detection and genotyping of HPV genotypes were done using a polymerase chain reaction (PCR) protocol. Results: PCR amplification was succesful in 61 of 77 patients. Among the 61 HNSCC patients only 3 patients were HPV positive(4.9 %). HPV 16 subtype was detected in one patient who was 70 years old male, stage III laryngeal cancer with a smoking history. The subtypes detected in other two patients were different from 16 and 18. One of these patients was 42 years old nonsmoker female stage IVa hypopharyngeal cancer and the other one was 56 years old smoker male with stage II oropharyngeal cancer. Conclusions: In Turkey, this is the first study that evaluated HPV positivity in HNSCC. Our results suggest a low prevelance of HPV in Turkish HNSCC patients; large scale population based studies are needed to confirm our findings.

Optimal cumulative cisplatin dose for radio-sensitization in locally advanced head and neck cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18553-e18553
Author(s):  
Atanu Bhattacharjee ◽  
Vanita Noronha ◽  
Vijay Maruti Patil ◽  
Anuja Abhayankar ◽  
Amit Joshi ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Head And Neck Cancer ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Neck Cancer ◽  
Squamous Cell ◽  
Cumulative Dose ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Free Survival

e18553 Background: Evidence to choose the optimum chemotherapy between weekly and 3 weekly cisplatin for prolonging the duration of progression free survival in head and neck squamous cell carcinoma (HNSCC) is equivocal. This urged us to look into the cumulative dose of chemotherapy rather than the frequency of administration i.e. weekly or 3 weekly. The aim of this study was to determine the optimal cumulative dose of cisplatin to improve the progression-free survival (PFS). Methods: Between January 2011 and January 2018, a total of 836 consecutive patients with histologically proven primary squamous cell carcinoma of the oral cavity, larynx, hypopharynx, and oropharynx were included. The effect of the cumulative dose on progression-free survival was studied to obtain the optimal cumulative dose of cisplatin. Results: A total of 11 cohorts were generated to represent the cumulative doses. The cumulative doses were measured at 30, 60, 90,120,150,180,200,210,240 and 300 mg/m2 respectively. The maximum duration of progression-free survival (PFS) was considered to define the best effective cumulative dose. Conclusions: This study confirms that a cumulative cisplatin dose of ~ 210 mg/m2 is optimum for increasing PFS in patients with head and neck cancer. Therefore, doses with weekly 30 mg/m2 for seven cycles or 3-weekly 70 mg/m2 for 3 cycles could be equally effective to prolong the PFS. Clinical trial information: CTRI/2012/10/003062, CTRI/2014/09/004980.

Immunotherapy in Patients with Recurrent and Metastatic Squamous Cell Carcinoma of the Head and Neck

2019 ◽  
Vol 19 (3) ◽  
pp. 290-303 ◽  
Author(s):  
Izabela Łasińska ◽  
Tomasz Kolenda ◽  
Anna Teresiak ◽  
Katarzyna M. Lamperska ◽  
Łukasz Galus ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Head And Neck Cancer ◽  
Cancer Treatment ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Neck Cancer ◽  
Squamous Cell ◽  
Locally Advanced ◽  
New Drugs ◽  
Radical Treatment

Background:Head and neck squamous cell carcinoma (HNSCC) is the most common malignant cancer occurring in the head and neck area, approximately 90% of the cases. Even in the cases of primary radical treatment (surgical, concomitant chemoradiotherapy or radiotherapy alone), subsequent local recurrence or distant metastases are often observed. In patients with recurrent disease who are unable to receive radical treatment, the results of palliative chemotherapy are not satisfactory. In this review, we summarized the standard treatment options, current development of new drugs and future perspectives in the treatment of patients with recurrent locally advanced and/or metastatic HNSCC.Methods:PubMed databases with words ‘head and neck cancer treatment’, ‘immunotherapy in head and neck cancer treatment’ were searched and yielded 186512 and 2249 papers respectively. We selected the most cited articles and reports presenting new immunotherapy agents and drug combinations in HNSCC.Results:Recently, two new agents been approved in the treatment of recurrent locally advanced and/or metastatic HNSCC. These are immune-checkpoint inhibitors targeting PD1 (nivolumab and pembrolizumab) which are the most active drugs in the second line treatment of advanced HNSCC. Still, the first line ‘golden standard’ is the chemotherapy regimen (cisplatin, 5-fluorouracyl) combined with cetuximab. Many phase 3 studies are currently ongoing, evaluating the efficacy of combinational treatment-anti-CTLA4 with anti-PD1 or anti-PDL1. Very encouraging results have been shown in early phase studies evaluating the combination of immunecheckpoint inhibitors with tumor microenvironment immunosuppressive inhibitors.Conclusion:Despite the huge progress in the systemic treatment of patients with recurrent locally advanced and/or metastatic HNSCC, the disease at this stage remains incurable. Undoubtedly, further research in the field of biomarkers for effective immunotherapy is needed in order to select a group of patients whose will benefit from this therapy, as the treatment is still ineffective in most patients.

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