Dr. Gold on Defining Head and Neck Squamous Cell Carcinoma

Kathryn A. Gold, MD, medical oncologist, associate professor of medicine, UC San Diego Heath, differentiates carcinogen-induced and virally associated head and neck squamous cell carcinoma (HNSCC).

HNSCC are 2 entirely different diseases, says Gold. HPV-negative squamous cell carcinoma is very different than HPV-positive squamous cell carcinoma, both biologically and clinically. These cancers need to be treated at 2 separated diseases, Gold says, and should not be grouped together solely because they occur in the same area of the body.

In HPV-negative disease, therapy must be intensified to get better outcomes, Gold says. For example, targeting CDK4/6 and other pathways that are possibly involved in cell cycle regulation in the recurrent and metastatic setting has been shown to improve results.

In HPV-positive disease, Gold says that focus needs to be put de-intensifying therapy, which could spare patients from unnecessary toxicities. Immunotherapy may be more important for HPV-positive disease, Gold explains, as there is an opportunity to target pathways such as PI3K. Therapeutic vaccines are another avenue of study in this group.