By Admin at 30 Mar 2018, 16:02 PM

Head and neck cancers, which include cancers of the larynx (voice box), throat, lips, mouth, nose and salivary glands, are among the latest showing exciting responses when treated with immunotherapies. Two immunotherapy agents — the immune checkpoint inhibitors, or PD-1 agents, nivolumab (Opdivo) and pembrolizumab (Keytruda) — have already been approved to treat head and neck cancers, particularly those that have progressed after treatment with platinum-based chemotherapy.

Ongoing clinical trials are now looking into immunotherapy drug combinations, as well as combinations of immunotherapy drugs, chemotherapy and radiation, that may provide a cure for more patients. In a study presented at the 2018 Multidisciplinary Head and Neck Cancers Symposium in Scottsdale, Arizona, for instance, nivolumab was found to be safe when administered along with radiation therapy and chemotherapy.

Previous research showed that adding nivolumab improved survival in head and neck cancer patients who had relapsed following chemotherapy. The current study is intended to reveal whether adding nivolumab to the initial treatment will prevent relapses from occurring. For the study, 20 patients received nivolumab in addition to radiation therapy as well as either weekly or high-dose chemotherapy (cisplatin) treatment. The early data shows the treatment was well received.

Lead study author Maura Gillison, M.D., Ph.D., professor of thoracic/head and neck medical oncology at the University of Texas MD Anderson Cancer Center in Houston, said in a news release, “We found that it is possible to add nivolumab immunotherapy to cisplatin treatment without compromising radiation delivery, and patients were also able to tolerate continuing immunotherapy for up to a year."[1]

Other immunotherapy agents have been doubling and tripling response rates, even leading to complete remission, by affecting processes in the tumor microenvironment that may have been missed by PD-1 agents, according to Ezra Cohen, M.D., professor of medicine, Division of Hematology/Oncology, associate director for Translational Science, Moores Cancer Center, University of California (UC), San Diego.

Entrectinib, which was granted breakthrough designation by the U.S. Food and Drug Administration (FDA) for certain indications in 2017, is another standout. A tyrosine-kinase inhibitor, entrectinib inhibits the NTRK gene, which can fuse with other elements in ways that activate the cancer. In an interview with OncLive, Cohen explained:[2]

“We presented a case of a patient with anaplastic thyroid cancer who had failed multiple lines of therapy, including chemotherapy, radiation, and other types of targeted therapies that are approved for thyroid cancer. We discovered that the tumor had this NTRK3 fusion and, within 10 days, the patient went from being dependent to being out of the hospital.”

There is hope that as current clinical trials continue, immunotherapy will become the first-line treatment for head and neck cancers, leading to cures for many and alleviating some of the potentially debilitating side effects, such as problems with speech and swallowing, that can occur with other treatments. Ultimately, immunotherapy shows immense promise at both extending survival and improving quality of life in people with head and neck cancer.

Sources
1. Astro February 13, 2018
2. OncLive October 25, 2017

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