Head and neck squamous cell carcinomas (HNSCCs) are the sixth leading cause of cancer worldwide
In 2012, 686.000 patients were diagnosed with HNSCC worldwide (Syrjanen & Syrjanen, 2019). These oropharyngeal cancers affect the tonsils, base of tongue and throat) . Risk factors include exposure to carcinogens, most notably tobacco smoking and alcohol consumption. Persistent infection with high-risk types of human papillomavirus (HPV) and genetic predisposition is also a high risk factor. HPV related incidence is rising rapidly amongst younger sexually active men and women.
HNSCC commonly presents with locally advanced disease, which has a recurrence rate of around 50% within 3 years despite aggressive multi-modality treatment involving surgery, radiotherapy and chemotherapy or EGFR inhibition where appropriate (Foster & Devlin, 2018).
As understanding of the underlying cancer biology and the complex interactions within the tumor microenvironment improves, there is growing interest in and evidence for the role of immunomodulating agents in the management of HNSCC.
Over the past years, anti-PD1 therapies have been approved in second and first line HNSCC therapy (Ferris et NEJM 2016, Cohen et al Lancet 2019, Burtness et al Lancet 2019).