Finally a breakthrough with immune checkpoint inhibitors?: New aspects of chemoradiotherapy of head and neck cancer Endlich der Durchbruch mit Immuncheckpointinhibitoren?: Neues in der Radiochemotherapie von Kopf-Hals-Tumoren
Schnellhardt S, Linxweiler M, Gostian AO, Hecht M (2025)
Publication Type: Journal article
Publication year: 2025
Journal
DOI: 10.1007/s11654-025-00668-7
Abstract
Current research into chemoradiotherapy (CRT) of nonmetastasized squamous cell carcinoma of the head and neck (HNSCC) is testing ways to safely deintensify treatment for human papillomavirus (HPV)-positive oropharyngeal cancer (OPC) while also investigating strategies for treatment escalation in locally advanced (LA)-HNSCC. Phase II studies on HPV-positive OPC have demonstrated that with appropriate patient selection, good oncological results can be achieved with reduced toxicity by drastically reducing the radiotherapy dose to as little as 30 Gy. One method of patient selection could be represented by hypoxia-sensitive imaging procedures. In HPV-negative LA-HNSCC, however, neither the combination of immune checkpoint inhibitors (ICIs) with definitive cisplatin-based CRT nor the additive use of the inhibitor of apoptosis protein (IAP) antagonist xevinapant with definitive CRT was able to improve prognosis in phase III trials. A new approach with positive preliminary trial results is perioperative immunotherapy with pembrolizumab, which led to a significant improvement in event-free survival (EFS) in resectable LA-HNSCC in combination with (C)RT in the phase III KEYNOTE-689 trial. Additive nivolumab therapy combined with postoperative CRT was also able to improve the prognosis in the preliminary results of the NIVOPOSTOP GORTEC 2018-01 study. In summary, cisplatin-based CRT remains the backbone of definitive and postoperative CRT. While treatment deintensification strategies for HPV-positive OPC can so far only be recommended in clinical trials, perioperative treatment of resectable LA-HNSCC with immune checkpoint inhibitors in combination with CRT could soon become the new standard of care.
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Germany (DE)How to cite
APA:
Schnellhardt, S., Linxweiler, M., Gostian, A.-O., & Hecht, M. (2025). Finally a breakthrough with immune checkpoint inhibitors?: New aspects of chemoradiotherapy of head and neck cancer Endlich der Durchbruch mit Immuncheckpointinhibitoren?: Neues in der Radiochemotherapie von Kopf-Hals-Tumoren. Best Practice Onkologie. https://doi.org/10.1007/s11654-025-00668-7
MLA:
Schnellhardt, Sören, et al. "Finally a breakthrough with immune checkpoint inhibitors?: New aspects of chemoradiotherapy of head and neck cancer Endlich der Durchbruch mit Immuncheckpointinhibitoren?: Neues in der Radiochemotherapie von Kopf-Hals-Tumoren." Best Practice Onkologie (2025).
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