Abstract
Recurrent locally advanced or metastatic head and neck squamous cell carcinoma (HNSCC) is associated with dismal prognosis because of its highly invasive behavior and resistance to conventional intensive chemotherapy. The combination of targeted therapy and conventional chemotherapy has significantly improved clinical outcomes. In recent years, the development of immunotherapies, such as immune checkpoint inhibitors (ICIs), has further increased treatment responses and prolonged survival. However, the limited response rate, risk of immunotherapy-related adverse effects and high cost of immunotherapy make the identification of predictive markers to optimize treatment efficacy a critical issue. Biomarkers are biological molecules that have been widely utilized to predict treatment response to certain treatments and clinical outcomes or to detect disease. An ideal biomarker should exhibit good predictive ability, which can guide healthcare professionals to achieve optimal treatment goals and bring clinical benefit to patients. In this review, we summarized the results of recent and important studies focused on HNSCC ICI immunotherapy and discussed potential biomarkers including their strengths and limitations, aiming to gain more insight into HNSCC immunotherapy in real world clinical practice.
Highlights
Head and neck cancer, mainly head and neck squamous cell carcinoma (HNSCC) developing from the mucosa of the nasal and oral cavity, oropharynx, hypopharynx, or larynx, is the sixth most common cancer type globally [1]
Based on the definition created by the U.S Food and Drug Administration (FDA) and the National Institutes of Health (NIH), a biomarker is a defined characteristic that can be used as a measureable indicator of normal biological condition, disease processes or responses to exposure or intervention [18]
In HNSCC, combined analysis of Immune checkpoint inhibitors (ICIs) pembrolizumab trials revealed that the tumor mutational burden (TMB), the combined positive score (CPS), and an inflamed gene expression profile (GEP) were three major parameters associated with the best overall response, regardless of human papillomavirus (HPV) infection status
Summary
Mainly head and neck squamous cell carcinoma (HNSCC) developing from the mucosa of the nasal and oral cavity, oropharynx, hypopharynx, or larynx, is the sixth most common cancer type globally [1]. With the rapid increase in approved indication and usage of ICIs in cancer treatment, how to achieve ideal treatment response, avoid toxicity, and reduce cost are emerging as important issues for related healthcare professionals in real world clinical practice. To address the above issues, several efforts have been made to improve the efficacy of ICIs, such as combination with other immunotherapeutic agents or conventional chemotherapy. Another strategy is to identify feasible biomarkers that can help select suitable patients who may obtain the most benefit from ICI treatment in real world clinical practice. We discuss emerging biomarkers and experimental models with predictive potential
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