HNSCC at a glance

Head and neck squamous cell carcinoma (HNSCC) is the seventh most common cancer worldwide, and accounts for 3% of all cancers.¹ Among all cancers occurring in the head and neck region including oral cavity, oropharynx, hypopharynx, and larynx, the squamous cell carcinoma histology accounts for approximately 90%.^1–3

According to the GLOBOCAN (global cancer statistics) 2020 report, approximately 890,000 new HNSCC cases are diagnosed each year with the incidence expected to increase by ~20% (1.08 million annual cases) by 2030.^2,4 In 2022 there were approximately 54,000 new cases and 11,230 deaths due to HNSCC in the United States alone.²
 

HNSCC five-year relative survival rate (US)*²

*Values are based on SEER 2022 five-year relative survival estimates.

Developments in HNSCC treatment

For localized HNSCC, the standard of care primarily consists of a surgical approach followed by radiation and adjuvant chemotherapy.^1,4 This is often the procedure recommended for tumors of the oral cavity and advanced tumors of the larynx and hypopharynx when functional preservation is not feasible.¹ In patients with localized disease with no clinical node involvement, or with only a single node involved, cure rates of over 80% have been achieved with single modality intervention (surgery or radiation).⁴

Despite the high cure rate for standard of care surgery, about 17–31% of these patients eventually undergo further radiation therapy and/or adjuvant chemotherapy due to disease recurrence.¹ For high-risk patients with post-surgical extra-nodal extension, close surgical margins, perineural invasion, or poor candidates for surgical management, chemoradiotherapy with single-agent cisplatin is recommended.^1,4 For recurrent, unresectable, or metastatic disease with no surgical or radiotherapy options, the preferred first-line regimens include pembrolizumab for tumors that express PD-L1 with combined positive score (CPS) ≥1, and pembrolizumab with platinum (cisplatin or carboplatin) and 5-fluorouracil (5-FU).⁵ Aside from pharmacological therapy, multidisciplinary and holistic care should be included as part of a patient’s treatment plan.⁴

5-FU, 5-fluorouracil; CPS, combined PD-L1 score; HNSCC, head and neck squamous cell carcinoma; PD-L1, programmed death ligand-1;  SEER, Surveillance, Epidemiology, and End Results; US, United States of America.