Immunotherapeutic strategies in patients with advanced head and neck squamous cell carcinoma

Most head and neck squamous cell carcinoma (HNSCC) patients present with advanced-stage disease often with significant rates of local failure and distant metastases (1). Over the past two decades, the survival rates of HNSCC patients have not been altered significantly by standard therapy (2). Immune dysfunction has been demonstrated in patients with HNSCC and this was correlated with either a defect of their antitumor immune responses and/or tumor progression and relapse (3). Immunotherapy has emerged as a promising treatment approach to improve such immune dysfunction. Interventions at immune checkpoints like CTLA-4, PD-1 and others are aimed at reconstituting immunosurveillance or T-cell mediated elimination of malignant cells. The effector and regulatory T cell compartments are targeted to resurrect an efficient T cells function. The assumption is that specific antigens are targeted and much debate is ongoing on what the most important target antigens may be mutated neo-antigens or constitutive cellular antigens like the cancer testis family of antigens (CTA) which are expressed preferentially in cancer cells like the MAGE family of antigens, NY-ESO-1 and others (4)