Head and neck cancer has one currently approved immunotherapy, the checkpoint inhibitor nivolumab (Opdivo®) and is one of the major cancer types for which new immune-based cancer treatments are in development. This page features information on head and neck cancer and immunotherapy clinical trials for head and neck cancer patients, and highlights the Cancer Research Institute’s role in working to bring effective immune-based cancer treatments to head and neck cancer patients.
While many different types of cancer can occur in the head and neck—including thyroid, salivary, and skin cancers—by far the most common type of cancer is squamous cell carcinoma of the head and neck (HNSCCA). Most HNSCCA begins in the layer of flat cells (the epithelium) which line the structures of the upper aerodigestive tract, including the mouth (oral cavity), throat (pharynx), and voice box (larynx).
HNSCCA accounts for about 3% to 5% of all cancers in the U.S. In 2016, an estimated 61,760 people will develop one of these cancers, and 13,190 individuals will die. The five-year survival rate of patients with head and neck cancer is about 60%.
Risk factors for head and neck cancers include: tobacco use, heavy alcohol consumption, prolonged sun exposure, and certain viruses, including human papillomavirus (HPV) and Epstein-Barr virus (EBV). In particular, HPV infection is a risk factor for oropharyngeal cancer (cancer of the middle of the throat, including the tonsils and base of tongue). The overall incidence of HPV-positive head and neck cancers is rapidly increasing in the U.S., while the incidence of HPV-negative (primarily tobacco- and alcohol-related) cancer is decreasing. While a strong causal relationship has been established between HPV type 16 and the development of oropharyngeal cancer, other HPV types have been associated with oropharyngeal cancer as well. HPV-related head and neck cancer has a unique risk factor profile, and a more favorable prognosis than tobacco or alcohol induced HNSCCA.
Head and neck cancer is highly curable—often with single-modality therapy (surgery or radiation)—if detected early. More advanced head and neck cancers are generally treated with multi-modality surgery, including various combinations of surgery, radiation, and chemotherapy. With any of these methods, the goal is not only to remove the cancer, but also to preserve the functions of the structures involved in speaking, swallowing, and expression. The checkpoint inhibitors nivolumab (Opdivo®) and pembrolizumab (Keytruda®) were approved in 2016 for patients with advanced head and neck cancer, and many other immunotherapies are being evaluated in clinical trials.
For a complete list of open clinical trials for head and neck cancer, see our Clinical Trial Finder.
- Cancer Research Institute (CRI) has a long history of supporting research into the link between viruses and cancer. In the late 1960s, Ted Boyse, Herbert Oettgen, and Lloyd J. Old demonstrated the association Epstein-Barr virus (EBV) and nasopharyngeal cancer, providing one of the earliest links between a virus and a human cancer. Since the 1970s, CRI has also supported the work of George Klein, at the Karolinska Institute in Sweden, on the relationship between EBV and cancer.
- Since 1994, Cancer Research Institute (CRI) has given out more than $4 million dollars for human papillomavirus (HPV) research. This has led to a number of clinical trials testing HPV vaccines, including one that was FDA approved in 2006 (Gardasil).
- In 2008, CRI funded John C. Herr, of the University of Virginia, to study CABYR as a biomarker for lung and head and neck squamous cell carcinomas.
I can’t overstate how lucky I am to have been in the exact right place, at the exact right time, to get a spot in the nivolumab trial.
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