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Clinical Application of Immunotherapy in the Perioperative Management of Head and Neck Cancer

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Immunotherapy for Head and Neck Cancer

Part of the book series: Cancer Immunotherapy ((CAIMUN,volume 1))

Abstract

Immunotherapy has changed the landscape of recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) and is now an essential element of frontline systemic therapy for such patients. Clinical trials have now begun to evaluate immunotherapy in the perioperative setting, including immune checkpoint inhibitors (ICI) as monotherapy or in combination with chemotherapy, or the use of IC with other immunomodulatory drugs. Accumulating data suggest that pathologic response to immunotherapy-based regimens translates to improved long-term outcome without contributing to operative delays, although multiple distinct schemas are in use to quantify response in trials and a unified approach is needed. Particularly impressive outcomes have been reported with neoadjuvant chemoimmunotherapy, where two small studies have reported complete responses in two thirds of HPV-positive patients. Several studies of perioperative ICI monotherapy suggest that programmed cell death 1 receptor ligand (PD-L1) expression enriches for benefit from immunotherapy. Although early data is promising, not all patients respond to immunotherapy, and further work is ongoing to identify predictive biomarkers, additional immune checkpoint targets or immunomodulatory combinations that will increase response. Perioperative studies provide an ideal platform for discovery, with the availability for baseline tissue and posttreatment resected tumor for correlative study.

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Author information

Authors and Affiliations

  1. Section of Hematology/Oncology, Department of Medicine, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USA

    Frederick M. Howard

  2. Otolaryngology-Head and Neck Surgery, The University of Chicago Medicine, Chicago, IL, USA

    Nishant Agrawal

  3. Head and Neck Surgical Oncology, The University of Chicago Medicine, Chicago, IL, USA

    Nishant Agrawal

  4. Surgery, Radiation Oncology, Comprehensive Cancer Center, The University of Chicago Pritzker School of Medicine, Chicago, IL, USA

    Nishant Agrawal

  5. Section of Hematology/Oncology, Department of Medicine, The University of Chicago Medicine, Chicago, IL, USA

    Ari J. Rosenberg

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  1. Frederick M. Howard
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  3. Ari J. Rosenberg
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Correspondence to Ari J. Rosenberg .

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Editors and Affiliations

  1. Sir YK Pao Centre for Cancer Hong Kong Cancer Institute, The Chinese University of Hong Kong, Hong Kong, China

    Anthony T. C. Chan

  2. Sir YK Pao Centre for Cancer Hong Kong Cancer Institute, The Chinese University of Hong Kong, Hong Kong, China

    Brigette B.Y. Ma

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Frederick M. Howard declares that he has no conflict of interest.

Ari Rosenberg reports advisory/consulting fees from Nanobiotix and EMD-serono.

Nishant Agrawal declares that he has no relevant conflict of interests.

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Howard, F.M., Agrawal, N., Rosenberg, A.J. (2022). Clinical Application of Immunotherapy in the Perioperative Management of Head and Neck Cancer. In: Chan, A.T.C., Ma, B.B. (eds) Immunotherapy for Head and Neck Cancer. Cancer Immunotherapy, vol 1. Springer, Cham. https://doi.org/10.1007/13905_2022_32

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  • DOI: https://doi.org/10.1007/13905_2022_32

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  • Print ISBN: 978-3-031-29225-5

  • Online ISBN: 978-3-031-29223-1

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