Novel Immunotherapeutic Approaches for Head and Neck Squamous Cell Carcinoma

Abstract

The immune system plays a key role in preventing tumor formation by recognizing and destroying malignant cells. For over a century, researchers have attempted to harness the immune response as a cancer treatment, although this approach has only recently achieved clinical success. Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide and is associated with cigarette smoking, alcohol consumption, betel nut use, and human papillomavirus infection. Unfortunately, worldwide mortality from HNSCC remains high, partially due to limits on therapy secondary to the significant morbidity associated with current treatments. Therefore, immunotherapeutic approaches to HNSCC treatment are attractive for their potential to reduce morbidity while improving survival. However, the application of immunotherapies to this disease has been challenging because HNSCC is profoundly immunosuppressive, resulting in decreased absolute lymphocyte counts, impaired natural killer cell function, reduced antigen-presenting cell function, and a tumor-permissive cytokine profile. Despite these challenges, numerous clinical trials testing the safety and efficacy of immunotherapeutic approaches to HNSCC treatment are currently underway, many of which have produced promising results. This review will summarize immunotherapeutic approaches to HNSCC that are currently undergoing clinical trials.

Keywords: head and neck squamous cell carcinoma; immune checkpoint inhibitors; immunotherapy; monoclonal antibody; oncolytic viruses; tumor vaccine.

Figure 1

Immunomodulatory actions of monoclonal antibodies on head and neck squamous cell carcinoma. CTLA-4: cytotoxic T-lymphocyte-associated protein 4; GITR: glucocorticoid induced tumor necrosis factor superfamily member 18-related protein; PD-1: programmed cell death protein-1; PD-L1: programmed death-ligand 1; EGFR: epidermal growth factor receptor; MET: MET proto-oncogene, receptor tyrosine kinase; HGF: hepatocyte growth factor; PI3K/Akt: phosphoinositide-3 kinase/Akt pathway; ERK: extracellular signal-regulated kinase.