About this Research Topic
Head and neck cancers include a multitude of malignancies that are categorized according to their primary sites such as the larynx, thyroid, tongue, and more. The majority of head and neck cancers fall under the category of head and neck squamous cell carcinoma (HNSCC), which is the seventh most common cancer worldwide. Standard-of-care treatment involves concurrent chemoradiation therapy with a platinum-based chemotherapy agent (e.g., cisplatin or carboplatin) or with cetuximab, a monoclonal antibody that targets EGFR. Unfortunately, an estimated 50% of locally advanced HNSCC patients recur locally or with metastatic disease after treatment and can consequently become platinum- or cetuximab-resistant. Patients with recurrent or metastatic disease have few treatment options and poor 5-year survival rates. Very little data has been published on why these tumors develop resistance to chemotherapy. Only a year ago, treatment in recurrent or metastatic HNSCC was limited to systemic chemotherapy.
Data from Keynote-048 demonstrated superior survival rates in first-line treatment with immune checkpoint inhibitors in HNSCC patients with positive PD-L1 expression. This clinical trial resulted in recent Food and Drug Administration (FDA) approval for pembrolizumab monotherapy in combination with chemotherapy as a first-line treatment for patients with recurrent or metastatic HNSCC. Patients with a Combined Positive Score (CPS) of ≥ 1 can now receive pembrolizumab in combination with cisplatin and fluorouracil (5-FU) while patients with a CPS ≥ 20 can receive pembrolizumab monotherapy.
With immunotherapy now being the standard-of-care treatment in HNSCC, further data and evaluation are necessary to understand why tumors become resistant in patients treated with immune checkpoint inhibitors.
This Research Topic will address the current status and future novel directions regarding the mechanisms of resistance in head and neck cancers. We encourage contributions focusing on the current role of immunotherapy, chemotherapy, and targeted therapy, novel and established mechanisms of resistance, and future directions in either of these aggressive diseases. We welcome Original Research, Systematic Review, Review, Mini Review, Perspective, Clinical Trial, Case Report, Data Report, and Opinion articles.
Data from Keynote-048 demonstrated superior survival rates in first-line treatment with immune checkpoint inhibitors in HNSCC patients with positive PD-L1 expression. This clinical trial resulted in recent Food and Drug Administration (FDA) approval for pembrolizumab monotherapy in combination with chemotherapy as a first-line treatment for patients with recurrent or metastatic HNSCC. Patients with a Combined Positive Score (CPS) of ≥ 1 can now receive pembrolizumab in combination with cisplatin and fluorouracil (5-FU) while patients with a CPS ≥ 20 can receive pembrolizumab monotherapy.
With immunotherapy now being the standard-of-care treatment in HNSCC, further data and evaluation are necessary to understand why tumors become resistant in patients treated with immune checkpoint inhibitors.
This Research Topic will address the current status and future novel directions regarding the mechanisms of resistance in head and neck cancers. We encourage contributions focusing on the current role of immunotherapy, chemotherapy, and targeted therapy, novel and established mechanisms of resistance, and future directions in either of these aggressive diseases. We welcome Original Research, Systematic Review, Review, Mini Review, Perspective, Clinical Trial, Case Report, Data Report, and Opinion articles.
Keywords: Head and neck cancer, mechanisms of resistance, immunotherapy, multimodality therapy
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