Immunotherapeutic Approaches

SZTURZ, Petr and Jan B. VERMORKEN. Immunotherapeutic Approaches. In Jan B. Vermorken, Volker Budach, C. René Leemans, Jean-Pascal Machiels, Piero Nicolai, Brian O'Sullivan. Critical Issues in Head and Neck Oncology. Switzerland: Springer International Publishing, 2017, p. 233-249. ISBN 978-3-319-42907-6. Available from: https://dx.doi.org/10.1007/978-3-319-42909-0_15.

Basic information

Original name

Immunotherapeutic Approaches

Authors

SZTURZ, Petr (203 Czech Republic, guarantor, belonging to the institution) and Jan B. VERMORKEN (56 Belgium)

Edition

Switzerland, Critical Issues in Head and Neck Oncology, p. 233-249, 17 pp. 2017

Publisher

Springer International Publishing

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Other information

Language

English

Type of outcome

Kapitola resp. kapitoly v odborné knize

Field of Study

30200 3.2 Clinical medicine

Country of publisher

Switzerland

Confidentiality degree

není předmětem státního či obchodního tajemství

Publication form

printed version "print"

RIV identification code

RIV/00216224:14110/17:00096006

Organization unit

Faculty of Medicine

ISBN

978-3-319-42907-6

DOI

http://dx.doi.org/10.1007/978-3-319-42909-0_15

Keywords in English

Head and neck cancer; Recurrent and metastatic; Immunotherapy; Immune escape; Immune checkpoint inhibitors; Pembrolizumab; Nivolumab; Durvalumab

Tags

EL OK, topvydavatel

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Abstract

V originále

Although the first reports on a potential association between cancer and the immune system date back to the nineteenth century, the establishment of immunotherapy as an adequate anticancer treatment modality took more than 150 years to complete, being accompanied by many obstacles and challenges. The basic concept behind immunotherapy is to restore the natural anticancer potential of the immune system. In broad terms, immunotherapy includes tumour-specific monoclonal antibodies, cancer vaccines, adoptive cell transfer and immune-modulating antibodies (e.g. immune checkpoint inhibitors). Building on their success in advanced melanoma, immune checkpoint inhibitors have received major attention in recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M-SCCHN). Pembrolizumab, a monoclonal antibody against programmed death-1 (PD-1) receptor, has been tested in the phase Ib trial KEYNOTE-012 achieving overall response and disease control rates of 25 % and 50 %, respectively. In a phase I/II study with durvalumab, a monoclonal antibody against programmed death ligand-1 (PD-L1), overall response and disease control rates were 11 % and 15 %, respectively. PD-L1 (but possibly also PD-L2) expression and interferon-gamma signature have emerged as promising predictive biomarkers, yet to be prospectively validated. In April 2016, results from a planned interim analysis of the phase III trial CHECKMATE-141 showed a statistically significant improvement in median overall survival (7.5 versus 5.1 months; p = 0.0101) achieved with nivolumab, an anti-PD-1 monoclonal antibody, versus single-agent chemotherapy (methotrexate, docetaxel) or cetuximab, defining thus a new standard of care in platinum-refractory R/M-SCCHN. Due to its distinctive mechanism of action, immunotherapy may not be recommended for patients with comorbid autoimmune disorders and those requiring prompt symptom relief. At present, six other ongoing randomized trials explore immune checkpoint inhibitors in the R/M-SCCHN setting with results to be expected in the first half of 2017.