Highlights on head & neck cancer 1

Dr Willem Lybaert, medical oncologist at VITAZ Sint-Niklaas and University Hospital Antwerp, presents highlights from the rapid oral abstract session on head & neck cancer

The phase 1 TARGET-HPV trial investigated the use of neoadjuvant HPV16-specific arenavirus-based immunotherapy HB-200 in conjunction with chemotherapy, followed by response-stratified de-intensification, in patients with HPV16+ oropharyngeal cancer. The findings indicate that this therapeutic approach is both safe and feasible, with preliminary evidence suggesting early signs of efficacy. Enrolment for the subsequent randomized phase II segment of the study is ongoing.

In the first-line treatment of patients with recurrent/metastatic HNSCC, the novel EGFR x LGR5 bispecific antibody, petosemtamab, in combination with pembrolizumab, exhibits a well-tolerated safety profile and demonstrates promising preliminary clinical efficacy.

Preliminary data from two novel ADCs, tisotumab vedotin and pucotenlimab in combination with EGFR-ADC MRG003, show promising results. Investigations are currently ongoing.

Relapsed or recurrent HNSCC presents a significant challenge in the second-line and subsequent treatment settings, with limited therapeutic options available. A considerable portion of these patients exhibit poor performance status and often receive best supportive care. However, in a randomized phase 3 superiority open-label trial focusing on HNSCC patients with ECOG PS 2-3, the implementation of triple metronomic chemotherapy resulted in a substantial enhancement in OS.

The KCSG HN18-07 phase II trial assessed the efficacy of triplet neoadjuvant chemotherapy, accompanied by prophylactic pegteograstim in patients with unresectable, locally advanced PNSNC. At a median follow-up of 21.5 months, the 2-year PFS reached 64%, while the preservation rate for ocular structures remained at 100%. These findings suggest that this regimen may represent a viable treatment option for patients diagnosed with locally advanced SCC of the PNSNC.

In a prospective single-arm comparative clinical trial, covalent FAPI PET was shown to facilitate precise management of MTC. The findings suggest that integrating covalent FAPI PET into the evaluation process at both the initial diagnosis and during persistent disease phases could significantly enhance the accuracy of MTC management.

Oral Potentially Malignant Disorders (OPMD) constitute a heterogeneous group of oral mucosal diseases that precede invasive oral SCC. In a phase 1 pilot study, intralesional injections of nivolumab were found to be well-tolerated in patients diagnosed with OPMD and seem to have potential clinical activity.