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    Potential of pembrolizumab in metastatic or recurrent head and neck cancer: Evidence to date

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    Author
    McCusker, M.G.
    Orkoulas-Razis, D.
    Mehra, R.
    Date
    2020
    Journal
    OncoTargets and Therapy
    Publisher
    Dove Medical Press Ltd.
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.2147/OTT.S196252
    Abstract
    Relapsed and/or metastatic head and neck squamous cell carcinoma (R/M HNSCC) is a heterogeneous disease previously associated with poor prognosis and limited treatment options until the advent and implementation of immune checkpoint inhibitors (ICIs). The fully humanized monoclonal antibody pembrolizumab alone, or in combination with chemotherapy, was shown to have significantly improved overall survival (OS) when compared to the standard of care (SOC) EXTREME regimen consisting of the monoclonal antibody cetuximab combined with a platinum and 5-fluorouracil. Pembrolizumab with or without chemotherapy will soon supplant the EXTREME regimen that has been in use for over a decade. Given the fast-approaching significant change in the treatment algorithm for R/M HNSCC and the novelty of ICIs in general, it is important to review the literature to date to understand how this rapidly growing treatment class has come about and explore potential areas of research for the plethora of questions that remain unanswered in selecting patients appropriate for treatment with ICIs in the R/M setting. In this review, we explore the landmark trials leading to the use of ICIs for R/M HNSCC with a particular focus on pembrolizumab, the most well-studied ICI in this setting. We also provide an overview of the rationale behind the use of ICIs in relation to the immune system and challenges surrounding tumor heterogeneity and PD-L1 expression status, human papilloma virus (HPV) and the efficacy of ICI, potential of radiation therapy for enhancement of ICI response, and complications of immune-related adverse events (irAEs). Copyright 2020 McCusker et al.
    Keyword
    Checkpoint inhibitors
    Head and neck cancer
    Immunotherapy
    Pembrolizumab
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85083861645&doi=10.2147%2fOTT.S196252&partnerID=40&md5=d0f4ed5c8f6602848f899e9ccd9dcfb2; http://hdl.handle.net/10713/12776
    ae974a485f413a2113503eed53cd6c53
    10.2147/OTT.S196252
    Scopus Count
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