Advertisement

Head and Neck Squamous Cell Carcinoma and Immunotherapy

An overview of the immunotherapy drugs that may be used in the treatment of head and neck cancers.

When treating head and neck cancer, PD-1 inhibitors may be used in combination with other cancer therapies, including chemotherapy.

Immunotherapy is a type of cancer treatment that helps the body’s immune system identify and fight cancer cells. It has been called the “fourth pillar of oncology,” following the three long-established treatment pillars of surgery, radiation therapy, and chemotherapy.

Along with surgery, radiation therapy, and chemotherapy (and targeted therapy), immunotherapy is being used in the treatment of head and neck cancers—more specifically, immunotherapy is being used in the treatment of head and neck squamous cell carcinomas.

What are squamous cell carcinomas?
The term head and neck cancer refers to numerous cancers that begin in the nose, sinuses, throat, mouth, and saliva-producing glands. Like other cancers, head and neck cancers begin with the uncontrolled growth of mutated cells.

The majority of head and neck cancers begin in cells called squamous cells—thin, flat cells that line hollow spaces in the body and are also found on the surface of the skin. Cancers that begin with these cells are called squamous cell carcinomas. Head and neck cancers of this type are called head and neck squamous cell carcinomas.

Head and neck squamous cell carcinomas account for roughly 90 percent of head and neck cancers. There are other types of head and neck cancers that are less common.

How does immunotherapy work?
Immunotherapies help the body’s immune system fight cancer cells. There are different types of immunotherapies that are used to treat different types of cancers. The immunotherapies being used in the treatment of head and neck squamous cell carcinomas are called immune checkpoint inhibitors.

Immune checkpoints are proteins found on healthy cells. These proteins protect healthy cells from immune cells, which detect and destroy harmful substances like pathogens, foreign substances, and mutated cells.

Some cancer cells also have high amounts of immune checkpoints. These help the cancer cells avoid detection by the immune system, allowing them to continue to duplicate, grow, and spread. In other words, immune checkpoints act as a disguise—cancer cells appear normal to the immune system.

Immune checkpoint inhibitors are drugs that block immune checkpoints, which helps the immune system detect and attack the cancerous cells.

There are several immune checkpoint inhibitors that are FDA-approved for the treatment of head and neck cancers. These medicines block an immune checkpoint called PD-1 and are given by infusion.

To determine if a cancer might respond to this type of therapy, a healthcare team can order laboratory tests that examine a sample of cancerous tissue to look for immune checkpoint proteins. This is known as biomarker testing.

PD-1 inhibitors may be used in combination with other cancer therapies, including chemotherapy.

Should you treat with immunotherapy?
Cancer is a different experience for every person—and the decision of how to treat the cancer is one that a person will need to make under the guidance of their healthcare team. Like other cancer treatments, PD-1 inhibitors can cause side effects, and in some cases can cause serious side effects. Potential side effects and what to do if you experience a side effect should always be discussed prior to beginning any treatment.

As a person living with head and neck cancer, it helps to understand the different treatment options and how they work. If you have questions about a particular treatment, your best source of information will be your healthcare team.

Article sources open article sources

NCI Dictionary of Cancer Terms. Immunotherapy.
National Cancer Institute. Immunotherapy to Treat Cancer.
Jasmine Aimaq. Immunotherapy: The Fourth Pillar of Cancer Care. Cedars Sinai. December 27, 2021.
Cerise M. Siamof, Shreya Goel, and Weibo Cai. Moving Beyond the Pillars of Cancer Treatment: Perspectives From Nanotechnology. Frontiers in Chemistry, 2020. Vol. 8.
National Cancer Institute. Head and Neck Cancers.
Hirofumi Shibata, Shin Saito, and Ravindra Uppaluri. Immunotherapy for Head and Neck Cancer: A Paradigm Shift From Induction Chemotherapy to Neoadjuvant Immunotherapy. Frontiers in Oncology, 2021. Vol. 11.
National Cancer Institute. What is Cancer?
NCI Dictionary of Cancer Terms. Squamous cell carcinoma.
MedlinePlus. Head and neck squamous cell carcinoma.
Penn Medicine Abramson Cancer Center. Oncology Social Workers. Squamous Cell Carcinoma of the Head and Neck.
National Cancer Institute. Immune Checkpoint Inhibitors.
American Cancer Society. Immune Checkpoint Inhibitors and Their Side Effects.
MedlinePlus. PDL1 (Immunotherapy) Tests.
UPMC Hillman Cancer Center. Immunotherapy for Head and Neck Cancer.
NCI Dictionary of Cancer Terms. PD-1.
Adriana Rendon and Appaji Rayi. Nivolumab. StatPearls. December 5, 2022.
James P. Flynn and Valerie Gerriets. Pembrolizumab. StatPearls. June 27, 2022.
U.S. Food & Drug Administration. FDA approves pembrolizumab for first-line treatment of head and neck squamous cell carcinoma. June 10, 2019.

Featured Content

article

What Are Your Treatment Goals for Head and Neck Cancer?

Why understanding treatment goals is essential to making treatment decisions when living with head and neck cancer.
article

What is the Best Treatment Option for Head and Neck Cancer?

A look at the different treatments that a person with head and neck cancer may discuss with their healthcare team.
article

What are the Different Types of Head and Neck Cancers?

Many types of cancer can affect the head and neck region, but only some cancers are categorized as head and neck cancers.
article

What to Ask When Starting Treatment for Head and Neck Cancer

What to ask your cancer care team about your treatment options, the potential risks and benefits, and follow-up care.
article

5 Ways to Find Support When Living with Head and Neck Cancer

Living with head and neck cancer can feel overwhelming, but you are not alone.