Immunotherapy redefines treatment for HNC, offers hope for advanced cases

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HEAD and neck cancer (HNC) ranks among the most common cancers worldwide, with higher incidence in developing countries. Risk factors include tobacco use, alcohol consumption, Human papillomavirus infection, and exposure to the Epstein-Barr virus, particularly for nasopharyngeal carcinoma — the most common HNC in the Philippines.

A NEW FORM OF TREATMENT June marks Immunotherapy Awareness Month, spotlighting how new cancer treatments like immunotherapy are reshaping care for complex diseases like head and neck cancer. In the Philippines, where nasopharyngeal cancer is highly prevalent, experts urge continued efforts to expand access to these innovative therapies. PHOTO FROM NGP

Aaron Hansen, a medical oncologist at Icon Cancer Centre in Australia and associate professor at the University of Queensland visited the Philippines to share his insights. He is also a member of the US National Cancer Institute Taskforce on Recurrent/Metastatic HNC.

Aaron Hansen, a medical oncologist at Icon Cancer Centre in Australia and associate professor at the University of Queensland. PHOTO FROM NGP

He emphasized the need for better awareness and earlier detection. "A persistent sore throat or neck lump might just be treated with antibiotics. After two or three rounds and no improvement, we need to start thinking — could this be cancer?"

Treatment for HNC typically depends on the tumor's location, stage, and patient condition. Surgery, chemotherapy, and radiation remain standard, but immunotherapy is increasingly gaining traction as a vital treatment option especially for advanced or metastatic cancers.

Unlike chemotherapy, which attacks tumors directly, immunotherapy reprograms a patient's immune cells to recognize and destroy cancer. "Cancers can camouflage themselves from the immune system. Immunotherapy removes that disguise, allowing immune cells to detect and kill the tumor," Hansen explained.

Immunotherapy may be used on its own or in combination with chemotherapy, depending on patient health and disease extent. For those who are frail or have multiple health issues, immunotherapy alone may be preferred due to its better tolerability. For fitter patients, a combined approach may yield better outcomes.

This breakthrough is now approved for a growing list of cancers including lung, liver, bladder, kidney, melanoma, lymphoma, and HNC. It also continues to expand with ongoing research.

Eligibility for immunotherapy is often guided by biomarker testing. In HNC, the key biomarker is the PD-L1 Combined Positive Score (CPS).

A higher PD-L1 CPS score indicates a better chance of responding to immunotherapy. For patients with low scores, combining immunotherapy with chemotherapy may be more effective.

Hansen emphasized that cancer care, especially for HNC, must go beyond just choosing the right medicine.

Tumors in the head and neck can significantly impact a patient's ability to eat, speak, or perform daily tasks. Even the ability to move one's shoulder or maintain facial appearance can be compromised. This makes the need for a supportive care team essential.

While immunotherapy shows great promise, its availability in the Philippines remains limited, especially in public health care settings. Treatments are often expensive and out of reach for many patients.

Hansen highlighted the importance of health system investment and advocacy. Government agencies and insurance programs must recognize the value of these therapies and find ways to make them more accessible.

Such trials could also demonstrate the strength of the Philippines' medical system and its potential for global partnerships in research and innovation.

As the burden of cancer continues to grow, especially in countries like the Philippines, the medical community, policymakers, and patient advocates must work together to close the access gap and give every patient a fighting chance.