Updates to Treatment of Recurrent Metastatic Head and Neck Cancers

Abstract

The introduction of immune checkpoint inhibitors (ICIs), such as pembrolizumab and nivolumab, has significantly improved overall survival in both the first- and second-line settings for patients with head and neck squamous cell carcinomas. In nasopharyngeal carcinomas, the combination of gemcitabine + cisplatin with PD-1 inhibitors has demonstrated impressive response rates and overall survival benefits. However, the unique immune-related adverse events associated with ICIs require patient counseling. Ongoing clinical trials are exploring novel combinations of ICIs with EGFR monoclonal antibodies, tyrosine kinase inhibitors, and therapeutic vaccines to further improve treatment outcomes. Biomarkers, such as circulating HPV-DNA and actionable molecular alterations (eg, HRAS mutations), may help guide treatment decisions and predict patient responses in the future.