“This is really the dawn of a new era in the treatment of head and neck cancer, particularly with immunotherapy,” said Brian Nussenbaum, MD, Director of Head and Neck Surgical Oncology at Washington University School of Medicine in St. Louis.

Brian Nussenbaum, MD

According to Dr. Nussenbaum, a better understanding is needed of the effects of chemoradiation therapy or radiation therapy in the absence of immunotherapy on the immune system, in order to best design clinical trials integrating immunotherapy.

“There might be different effects on the immune system in terms of the radiation schedule (such as standard fractionation, hyper- or hypofractionation), and we need to better understand if radiation and immunotherapy synergize with each other in terms of oncologic effects and toxicities,” said Dr. ­Nussenbaum. “It is important to determine when is the best timing to administer immunotherapy in the curative setting, whether that is neoadjuvant or adjuvant, and whether it is concurrent with radiation or chemoradiation.” ■

Disclosure: Dr. Nussenbaum reported no potential conflicts of interest.