Key Points
➤ ➤ Squamous cell carcinoma of the head and neck (HNSCC) is the 9th leading
cancer by incidence worldwide and constitutes 90% of all head and neck
cancers.
➤ ➤ HNSCC is a biologically diverse and genomically heterogeneous disease that
arises from the squamous mucosal lining of the upper aerodigestive tract.
➤ ➤ In addition to traditional risk factors including smoking and alcohol
consumption, over the last two to three decades it has become apparent that
the human papillomavirus (HPV) and Epstein Barr Virus (EBV) are associated
with development of squamous cell carcinoma of the oropharynx and
nasopharynx, respectively.
➤ ➤ Despite advances in surgery and radiotherapy, five-year survival rates for
patients (excluding EBV-related nasopharyngeal) with HNSCC across all stages
remain 40-50% for tumors caused by the traditional carcinogens smoking and
alcohol consumption.
➤ ➤ Between 2016 and 2019, the US Food and Drug Administration (FDA)
approved two immunotherapeutic agents, the anti-programmed cell death
protein (PD-1) monoclonal antibodies, nivolumab (Opdivo, Bristol-Myers
Squibb) and pembrolizumab (Keytruda, Merck), for the treatment of patients
with recurrent/metastatic (R/M) HNSCC.
➤ ➤ Anti-PD-1/PD-L1 ICIs can block suppressive signaling of T cell immunological
responses through the PD-1/PD-L1 pathway and enhance antitumor immune
activity.
