Abstract
Treatment of recurrent or metastatic squamous cell carcinoma of the head and neck has grown increasingly more complex with the development of new immunotherapy agents as well as novel combinations of immunotherapy with existing cytotoxic chemotherapy and targeted agents. With the advent of new immunotherapy agents, the overall survival of patients with metastatic disease continues to improve, although there is still an unmet need for patients with continued disease progression. Immunochemotherapy may offer additional benefits with increased response rate as well as durable response. The combination of both immunotherapy and cytotoxic chemotherapy may also offer an improved toxicity profile while improving efficacy, although clinical trials are ongoing, and the data is still maturing. Further investigations into biomarker testing and new scoring systems of PD-L1 expression levels are still being evaluated. Traditionally, the tumor positive score (TPS) had been utilized as a benchmark for defining patient populations; however, emerging data using a combined positive score (CPS) may offer additional insight regarding the benefit of PD-1 inhibitors.
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