HEAD & NECK CANCERS

The FDA approval of pembrolizumab as a treatment for patients with recurrent or metastatic head and neck squamous cell carcinoma in August 2016 was extremely significant for this patient population, which previously had limited options following progression on a platinum-based chemotherapy.

The FDA has approved the PD-1 inhibitor pembrolizumab as a second-line therapy for patients with recurrent or metastatic head and neck squamous cell carcinoma for those who have progression on a platinum chemotherapy. 

Although paradigms for treating older patients with head and neck cancer are not well defined, advancements in targeted and immunotherapies and less toxic radiation regimens suggest that physicians can aim for a more individualized approach to treating this patient population.

The FDA has agreed to review nivolumab under an accelerated timeframe for its potential as a treatment for patients with previously treated metastatic or recurrent squamous cell carcinoma of the head and neck.

Review of the currently available and approved therapeutic agents for the management of metastatic squamous cell NSCLC and clinical trials focusing on targeted therapy.

Given the lack of treatment options for patients with recurrent/metastatic head and neck squamous cell carcinoma, the need for novel therapies is dire.

Squamous cell carcinoma of the head and neck (SCCHN) is an immunosuppressive disease, as its patients often demonstrate immune dysregulation that correlates with poorer outcomes. Trials are underway combining chemoradiotherapy with immune checkpoint inhibitors.

Pembrolizumab (Keytruda), when studied in 2 clinical trials for the treatment of patients with pretreated recurrent or metastatic head and neck squamous cell carcinoma (HNSCC), showed an objective response rate (ORR) of 18%, according to findings presented at the 2016 ASCO Annual Meeting.

Infusion with 19-28z chimeric antigen receptor (CAR) modified T-cells led to complete response (CR) rates of 77% to 90% and minimal residual disease (MRD)-CR rates of 68% to 70% in adult patients with relapsed or refractory B-cell acute lymphocytic leukemia (B-ALL).

Nivolumab (Opdivo) monotherapy showed improved overall survival (OS) and objective response rates for patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) compared with the investigator's choice of alternative therapy, according to data presented at the 2016 ASCO Annual Meeting.

Neratinib, an experimental TKI being developed for breast cancer, achieved a 36% clinical benefit rate in a phase II trial, according to a poster presented June 5, 2016 at the ASCO Annual Meeting in Chicago.

Since its first FDA approval in squamous cell carcinoma of the head and neck (SCCHN) in 2006, cetuximab (Erbitux) has helped oncologists make significant strides in treating patients with the disease.

Nivolumab (Opdivo) has been granted a breakthrough therapy by the FDA as a treatment for patients with recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN) following a platinum-based therapy.

The FDA has granted a priority review designation to pembrolizumab (Keytruda) as a treatment for patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) following a platinum-based chemotherapy, according to a statement from Merck, the company developing the PD-1 inhibitor.

The combination of pazopanib (Votrient) and cetuximab (Erbitux) showed a disease control rate of 77% in patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC).

Adding cetuximab (Erbitux) to induction chemotherapy and hyperfractionated or accelerated chemoradiation therapy produced long-term control for patients with HPV-, locoregionally advanced head and neck squamous cell carcinoma with a poor prognosis.

The multikinase inhibitor lenvatinib (Lenvima) has quickly become the frontline standard of care for patients with progressive, radioactive iodine (RAI)-refractory differentiated thyroid cancer (DTC), just one year following its initial approval, according to Renato Martins, MD.

The panel, which included experts in oncology, dentistry, nursing, speech pathology, and primary care, conducted a systematic literature review to develop these consensus-based management strategies for HNC survivors. Their search identified 2081 articles, of which 184 were ultimately included in the evidence base.

In an interview, Frakes discusses a recent study and the impact these data have on follow-up frequency and the overall treatment paradigm for patients with OPSCC.

The two platforms involved in the study were the FHX regimen and a cisplatin radiation approach with accelerated radiation. Siltuximab was also used in the study as induction chemotherapy alongside carboplatin and paclitaxel.

Churilla said the majority of patients on a national level had insurance, with only 15% of patients utilizing medicaid and 5% of patients being uninsured.

Nussenbaum says the current balance in the treatment paradigm of larynx cancer is between surreal and cure, all while maintaining a functional preservation for the patient.

Biomarkers ultimately hold the key to improving both progression-free survival and overall survival with second-line afatinib in patients with recurrent or metastatic head and neck squamous cell carcinoma.

A neoadjuvant combination of motolimod plus cetuximab was found to increase the immune responses in both the blood and tumor microenvironment for patients with head and neck squamous cell carcinoma.

Frakes says the number of HPV-positive oropharyngeal cancer diagnoses year to year is growing, though the number of survivors is proportionate.