Dr. Saba Discusses Ongoing Research in Head and Neck Cancer

Nabil F. Saba, MD, FACP, director, Head and Neck Medical Oncology Program, Winship Cancer Institute of Emory University, professor, Department of Hematology and Medical Oncology, Department of Otolaryngology, Emory University School of Medicine, discusses ongoing research in squamous cell carcinoma of the head and neck.

Checkpoint inhibitors were first evaluated in the post-platinum setting and have since shown benefit in the frontline setting, says Saba. For example, in the phase III KEYNOTE-048 trial, pembrolizumab (Keytruda) demonstrated a 22% reduction in the risk of disease progression or death versus the standard EXTREME regimen of cetuximab (Erbitux) with carboplatin or cisplatin plus fluorouracil, in patients with PD-L1—positive tumors. These data led to the FDA approval of the PD-1 inhibitor for the frontline treatment of patients with metastatic or unresectable recurrent disease whose tumors express PD-L1.

In light of these data, the majority of patients are not receiving cytotoxic chemotherapy or targeted therapy in the frontline setting. As such, there has been a resurgence of interest in evaluating EGFR inhibitors, such as cetuximab, as monotherapy as well as in combination with immunotherapy post-progression. Combination strategies are likely to become a focus of research, adds Saba, following encouraging activity with lenvatinib (Lenvima) and pembrolizumab in patients with metastatic disease who progressed on ≥1 prior therapy.