There’s some good news in the treatment of head and neck squamous cell cancers: New treatments are moving us closer to directly targeting and destroying these cancers and easing the debilitating side effects that hurt some patients.
Head and neck squamous cell cancers develop in the mouth, nose and throat. About 50,000 new cases are diagnosed every year in the U.S. The biggest risk factors for these cancers are tobacco use and heavy drinking.
Treatment for head and neck squamous cell cancers typically has included surgery, chemotherapy and radiation. For many years, the standard chemotherapy agents were quite toxic and carried a high risk of side effects. Even now, the gold standard of chemo for these cancers is considered to be cisplatin, which can cause significant side effects during treatment and later chronic side effects that can last a lifetime.
Targeting cancer cells at the molecular level
In 2006, the Federal Drug Administration approved cetuximab (sold as Erbitux by Eli Lilly and Co.) for treating head and neck squamous cell cancers. It was the first chemotherapy approved by the FDA in 45 years specifically for these cancers.
Cetuximab was the fruit of intense molecular research and engineering, and a breakthrough moment in the pursuit of the targeted obliteration of cancer cells at a molecular level.
Further molecular and immunologic research has resulted in two more drugs to treat head and neck squamous cell cancers. Both are immunotherapies, which turbocharge our immune system to fight cancer cells.
Immunotherapy moves treatment forward
The FDA approved Pembrolizumab (sold as Keytruda by Merck Sharp & Dohme Corp.) and nivolumab (sold as Opdivo by Bristol-Myers Squibb Co.) in the second half of 2016. These agents target the immune checkpoints of the human body and zero in on PD-1 receptors on T-cells, the good guys that kill cancer cells.
We are living in an exciting era when scientists and physicians are inching closer and closer to the key that will enable us to target and eradicate cancers and, at the same time minimize the side effects caused by cancer treatment.
As a surgeon treating head and neck cancer patients, I am eagerly awaiting the time when I’m relegated to the sideline, where I will observe with awe the monumental changes that have taken place in such a short time.