Assuntina G. Sacco, MD, assistant professor of medicine, medical oncologist, UC San Diego Health, discusses ongoing trials investigating chemoradiation for patients with head and neck cancer.

For patients with locally advanced disease who are going to receive chemoradiation, there are 2 ongoing trials. One trial is involving the addition of immunotherapy, specifically pembrolizumab (Keytruda), as both a lead-in phase given concurrently throughout chemotherapy and radiation, and then as an adjuvant treatment. That study was designed by Sanford Health; Dr Kathryn A. Gold is the principle investigator at UC San Diego Health, says Sacco.

The second trial is a Pfizer-sponsored trial called JAVELIN. This is for patients with high-risk head and neck cancer, and involves high-dose cisplatin with radiation. They may also receive placebo or a PD-L1 inhibitor, specifically avelumab (Bavencio), which is given as a lead in, concurrent throughout chemoradiation, and then in the maintenance phase, which is up to 1 year, explains Sacco.

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Dr. Sacco on Ongoing Trials for Chemoradiation in Head and Neck Cancer

Assuntina G. Sacco, MD, assistant professor of medicine, medical oncologist, UC San Diego Health, discusses the importance of multidisciplinary care in the treatment of patients with head and neck cancer.

Sacco says that multidisciplinary care is more important than ever in head and neck cancer. Collaboration between surgeons, radiation oncologists, medical oncologists, and speech language therapists is vital—no one specialist can do it alone, she emphasizes.

Additionally, dietitians should be involved, as they can assist in minimizing weight loss and reduce the potential for a feeding tube, which some patients with head and neck cancer end up needing. The incorporation of dietitians and speech pathologists can even expedite the removal of feeding tubes, as well as improving swallowing mechanisms.

Patients with head and neck cancer undergo a lot of toxicity during their rigorous treatment course, Sacco explains. These patients need intensive support throughout the care continuum, especially in the months of recovery that follow treatment.

Assuntina G. Sacco, MD, assistant professor of medicine, medical oncologist, UC San Diego Health, discusses the importance of multidisciplinary care in the treatment of patients with head and neck cancer. 
 

Dr. Sacco Discusses Multidisciplinary Care in Head and Neck Cancer

Data suggests that higher-dose cisplatin is superior to weekly-dose regarding local regional control. There is a trend to improved disease-free survival and overall survival, however further research is needed. 

Assuntina G. Sacco, MD, assistant professor of medicine, medical oncologist, UC San Diego Health, discusses upfront treatment for patients with head and neck cancer.

Assuntina G. Sacco, MD

Articles

Dr. Sacco on Ongoing Trials for Chemoradiation in Head and Neck Cancer

Dr. Sacco Discusses Multidisciplinary Care in Head and Neck Cancer

Dr. Sacco on Upfront Treatments for Head and Neck Cancer