Immunotherapy - A New Pillar in Head and Neck Cancer Therapy

Head and Neck cancer (HNC) frequently presents with poor prognosis and a high death rate. Furthermore, as the survival rates are low and the currently used treatment modalities are toxic, there is a marked need for more efficient therapeutic regimens. Immune system dysfunction plays a role in both the development and progression of HNC, highlighting the potential role for immunotherapy to improve outcomes in this disease. HNC shows immune evasion through multiple mechanisms and particularly creates an immunosuppressive microenvironment by causing activation of inhibitory immune cells, release of suppressive factors and reduction in tumor immunogenicity. Research on these suppressive and evasive mechanisms has enabled immunotherapies, some of which may potentially be successful. Currently in HNC, only immune checkpoint inhibitors have proven clinical efficacy in randomized phase III trials. This chapter summarizes current knowledge of the role of the immune system in HNC, and provides a comprehensive overview on the challenges during immunotherapy in HNC.