Dr. Weiss on Next Steps for Immunotherapy in Head and Neck Cancer

Jared Weiss, MD, assistant professor, UNC Lineberger Comprehensive Cancer Center, discusses next steps for immunotherapy agents in the treatment of patients with head and neck cancer.

On the horizon, Weiss sees immunotherapy agents, such as nivolumab (Opdivo) and pembrolizumab (Keytruda), moving into the frontline setting of head and neck cancer treatment. Multiple studies are currently trying to tease out the benefits and drawbacks of chemotherapy versus PD-1/PD-L1 agents alone, versus the combination of PD-1/PD-L1 agents with CTLA4 agents. those trials are near accruing. Weiss expects these data within the next year, with legitimate maturity approximately 1 or 2 years after that.

However, he also says it is important to note that, in contrast to lung cancer, for example, most head and neck cancer incidences are not incurable. In fact, the overwhelming majority of these patients present with locally advanced disease that is treated for cure, he explains.

From a perspective of duration and quality of life in this setting, Weiss says that curative therapy is actually where oncologists should begin to direct their focus. Treatments in this space, such as radiation therapy and cisplatin, are rather difficult for patients to tolerate, with adverse events including long-term loss of speaking and swallowing function, mild hearing loss, and neuropathy, among other toxicities.