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Review
. 2021 May 24;13(11):2573.
doi: 10.3390/cancers13112573.

Paradigm Change in First-Line Treatment of Recurrent and/or Metastatic Head and Neck Squamous Cell Carcinoma

Edith Borcoman  1 , Gregoire Marret  1 , Christophe Le Tourneau  1   2   3
Affiliations
Review

Paradigm Change in First-Line Treatment of Recurrent and/or Metastatic Head and Neck Squamous Cell Carcinoma

Edith Borcoman et al. Cancers (Basel). .

Abstract

Cetuximab, a monoclonal antibody targeting the epidermal growth factor receptor (EGFR) in combination with platinum-based chemotherapy has been for the decade standard of care for the treatment of head and neck squamous cell carcinomas (HNSCC) patients in the first-line recurrent and/or metastatic setting. The KEYNOTE-048 trial published last year established a new paradigm in this setting with the demonstration that immunotherapy should be given either alone or in combination with chemotherapy. Indeed, pembrolizumab, an antiprogrammed cell death 1 (PD-1) immune checkpoint inhibitor, improved overall survival as compared to the EXTREME regimen in patients expressing PD-L1 in the tumor microenvironment, which represents a large majority of the patient population. In this review, we will decipher this important change of paradigm in the first-line treatment of recurrent and/or metastatic HNSCC, and discuss associated challenges.

Keywords: PD-L1; first-line treatment; head and neck squamous cell carcinoma; immunotherapy.

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Conflict of interest statement

C.L.T. participated in advisory boards from Merck Sharp and Dohme, Bristol-Myers Squibb, Merck Serono, GSK, Celgene, Roche, Rakuten, Nanobiotix, Seattle Genetics, Astra Zeneca. Others declared no conflicts of interest.

Figures

Figure 1
Figure 1
Proposed treatment algorithm in the first line setting for patients with recurrent and/or metastatic HNSCC.
Figure 2
Figure 2
Proposed treatment algorithm in the second-line setting for patients with recurrent and/or metastatic HNSCC. * Patients with progression within 3 months following platinum containing chemotherapy for locoregional disease excluded.
Figure 3
Figure 3
Proposed treatment algorithm for recurrent and/or metastatic HNSCC patients after exposure to first-line immunotherapy +/− chemotherapy.
See this image and copyright information in PMC

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