Dr. Lopes on Immunotherapy in Head and Neck Cancer

Gilberto Lopes Jr, MD, a medical director for International Programs at Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, discusses the role of immunotherapy for patients with head and neck cancer.

Two of the major groups of patients with head and neck cancer are those who have HPV-related disease and those who do not, explains Lopes. For patients who were entered in trials investigating immunotherapy, it did not seem that having an HPV infection interfered with results. Patients who have PD-L1-positive disease did experience better responses.

There are 2 large randomized phase III trials, one which was clearly positive with the use of nivolumab (Opdivo), and one that trended to be positive with the use of pembrolizumab (Keytruda), states Lopes. Both drugs are available for patients who have failed initial therapy. Standard initial therapy involves a platinum therapy or cetuximab.

For patients in the locally advanced setting, immunotherapy is not used, but there are potential options. Patients who can receive concurrent chemoradiation are usually treated with cisplatin, and patients who cannot can often benefit from the addition of cetuximab to radiation.