Release Date: 2024-06-12

Immunotherapy in Brain, Head and Neck Cancer

Ozan Yazici (Author), Imdat Eroglu (Author), Nuriye Ozdemir (Author)

Release Date: 2024-06-12

Besides immunotherapy, several other pathways are targeted in Head and Neck (HNC) for future treatment. HRAS, NTRK, MSI, NOTCH, and PIK3A are targetable pathways for HNC. Tipifarnib showed promising results in patients with HNC having HRAS mutation in phase 2 studies. Xevinapant, a potent oral inhibitor of the apoptosis proteins antagonist, is another novel molecule [...]

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    Work TypeBook Chapter
    Published inImmunotherapy in Human Cancers
    First Page151
    Last Page166
    DOIhttps://doi.org/10.69860/nobel.9786053359388.11
    Page Count16
    Copyright HolderNobel Tıp Kitabevleri
    Licensehttps://nobelpub.com/publish-with-us/copyright-and-licensing

    Besides immunotherapy, several other pathways are targeted in Head and Neck (HNC) for future treatment. HRAS, NTRK, MSI, NOTCH, and PIK3A are targetable pathways for HNC. Tipifarnib showed promising results in patients with HNC having HRAS mutation in phase 2 studies. Xevinapant, a potent oral inhibitor of the apoptosis proteins antagonist, is another novel molecule tested as a treatment option in HNC. A phase 2 trial showed that the addition of xevinapant to the CRT in locally advanced HNC results in very promising 5-yr OS benefits (53 % vs 28 %) compared to the CRT+placebo ( Multiomic studies (especially genomic and transcriptomic) are going on. Using multi-omics for the guidance of treatment could increase the PFS of the patients.
    Pembrolizumab is recommended alone or in combination with cisplatin /carboplatin and 5-FU chemotherapy, especially in tumors with PD-L1 CPS ≥ 1 for metastatic/unresectable disease in the first-line treatment. Single-agent pembrolizumab is an acceptable treatment choice especially in patients with CPS ≥ 20. Nivolumab and pembrolizumab are also recommended in subsequent lines if disease progression occurs after the first platinum-based treatment. For locally advanced HNC, studies on nivolumab and pembrolizumab with radiation therapy or CRT are mainly based on safety data and are immature. Although KEYNOTE-412 failed to show event-free survival and OS benefit when combined with CRT, patients with high PD-L1 expression may improve clinically. Although neoadjuvant immunotherapy showed promising results in phase 2 studies, further phase 3 studies are required to use it as a standard treatment option. HNCs are a heterogeneous group of cancers with different etiological, anatomical, and tumor microenvironmental features. Combining the different immunotherapies and chemotherapy with immunotherapy could be an acceptable option to overcome these barriers. Besides immunotherapy, several novel pathways are under investigation for targeted therapies in patients with HNC.

    Nuriye Ozdemir (Author)
    MD, Professor of Internal Medicine, Gazi University
    https://orcid.org/0000-0002-9235-9592
    3Nuriye Özdemir Academical tittle Prof. Dr. Affillation Gazi Üniversitesi Tıp Fakültesi A. EDUCATION Year Speciality Affillation Degree 2018 Medical Oncology Ankara Yıldırım Beyazıt University Assoc. Prof. Dr. 2011 Medical Oncology Ankara Numune Education and Research Hospital M.D. (Specialist) 2007 Medical Oncology Ankara Yıldırım Beyazıt University M.D. (Specialist) 2002 Medical Oncology Ankara Numune Education and Research Hospital Research Asistant 1996 Tıp Fakültesi Ankara University Faculty of Medicine M.D.

    Imdat Eroglu (Author)
    MD, Assistant Professor, Gazi University
    https://orcid.org/0000-0001-6619-4141
    3IMDAT EROĞLU Gazi University Faculty of Medicine, Department of Medical Oncology,Research/Clinical Fellowship (2023-…) Hacettepe University Faculty of Medicine, Department Internal Medicine, Research Assistant (2018-2023 ) Gazi University Faculty of Medicine (2010 – 2017) Current: Oncology trainee: Gazi University Facult of Medicine/Turkey Oct 2023 Internal Medicine Specialist: Muradiye State Hospital/Turkey Feb 2023- Oct 2023 Internal Medicine Research Assistant: Hacettepe University /Turkey May 2018-Feb 2023 Observership: Medical University of Warsaw, Transplantation Surgery/Poland Aug 2014 Hacettepe University Faculty of Medicine, Turkey 2022

    Ozan Yazici (Author)
    MD, Professor of Internal Medicine, Gazi University
    https://orcid.org/0000-0003-0038-3569
    3Medical Student Faculty of Medicine Hacettepe University 2006 Research Assistant İç Hastalıkları Anabilim Dalı/İç Hastalıkları Ankara University Faculty of Medicine 2011 M.D.Subspecialist Education Medical Oncology Ankara Numune Education and Research Hospital 2014 Assoc. Prof. Medical Oncology Gazi University 2018-2022 Proföser Tıbbi Onkoloji Bilim Dalı Gazi University 2022-

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