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Swiss Med Wkly. 2018 May 14;148:w14625. doi: 10.4414/smw.2018.14625. eCollection 2018.

Immunotherapy in head and neck cancer - scientific rationale, current treatment options and future directions.

Author information

1
Division of Otorhinolaryngology, Head and Neck Surgery, Cantonal Hospital Olten, Switzerland.
2
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Basel, Switzerland.
3
Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany / Centre for Molecular Medicine Cologne (CMMC), Cologne, Germany / Department of Otorhinolaryngology, Head and Neck Surgery, Grosshadern Medical Centre, Ludwig-Maximi.
4
Department of Otorhinolaryngology, Head and Neck Surgery, Grosshadern Medical Centre, Ludwig-Maximilians-University of Munich, Germany / Department of General, Visceral and Cancer Surgery, University of Cologne, Germany.
5
Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Göttingen, Georg August University, Göttingen, Germany.
6
University Hospital Basel, Department of Internal Medicine, Medical Oncology, Basel, Switzerland / Cancer Immunology, Department of Biomedicine, University of Basel, Switzerland.

Abstract

Head and neck squamous cell carcinoma (HNSCC) is a frequent tumour arising from multiple anatomical subsites in the head and neck region. The treatment for early-stage disease is generally single modality, either surgery or radiotherapy. The treatment for locally advanced tumours is multimodal. For recurrent/metastatic HNSCC palliative chemotherapy is standard of care. The prognosis is limited and novel treatment approaches are urgently needed. HNSCC evades immune responses through multiple resistance mechanisms. HNSCC is particularly characterised by an immunosuppressive environment which includes the release of immunosuppressive factors, activation, expansion of immune cells with inhibitory activity and decreased tumour immunogenicity. An in-depth understanding of these mechanisms led to rational design of immunotherapeutic approaches and clinical trials. Currently, only immune checkpoint inhibitors, namely monoclonal antibodies targeting the immune inhibitory receptor programmed cell death 1 (PD-1) and its ligand PD-L1 have proven clinical efficacy in randomised phase III trials. The PD-1 inhibitor nivolumab is the only drug approved for platinum-refractory recurrent/metastatic HNSCC. However, many more immunotherapeutic treatment options are currently under investigation. Ongoing trials are investigating immunotherapeutic approaches also in the curative setting and combination therapies using different immunotherapeutic approaches. This review article summarises current knowledge of the role of the immune system in the development and progression of HNSCC, and provides a comprehensive overview on the development of immunotherapeutic approaches.

PMID:
29756633
DOI:
10.4414/smw.2018.14625
[Indexed for MEDLINE]
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