Dr. Saba on Anticipated Research in Head and Neck Cancer

Nabil F. Saba, MD, FACP, director, Head and Neck Medical Oncology Program, Winship Cancer Institute, Emory University, and professor, Department of Hematology and Medical Oncology, Department of Otolaryngology, Emory University School of Medicine, discusses anticipated research in head and neck cancer.

Several trials with the potential to shift current sequencing strategies are anticipated in head and neck cancer, says Saba. One example is the phase III JAVELIN Head and Neck 100 trial, in which patients with locally advanced squamous cell carcinoma of the head and neck will be randomized to receive standard of care chemoradiotherapy plus avelumab (Bavencio) or chemoradiotherapy alone. If these data are positive, they would change the way concurrent therapy is approached in the field, says Saba.

At the 2019 ESMO Congress, safety data were reported from the phase III REACH trial, in which patients with locally advanced disease were randomized to receive avelumab, cetuximab (Erbitux), and radiotherapy, or cetuximab and radiotherapy alone. The regimen was found to be safe, but efficacy data are still outstanding.

A phase III study (NCT03452137) evaluating atezolizumab (Tecentriq) as adjuvant therapy after definitive local therapy in high-risk patients is also underway. Notably, HPV-positive and HPV-negative patients were eligible for enrollment in the trial, says Saba. Given that HPV-negative patients have a worse prognosis than HPV-positive patients, it may be that the data are driven by the latter group.

Finally, the phase II/III ECOG-ACRIN EA3161 trial recently launched and is evaluating maintenance nivolumab (Opdivo) following cisplatin and radiation in intermediate-risk, HPV-positive patients, Saba concludes.