ESMO 2025 | Unmet needs and future directions in in head and neck cancer
Andreas Dietz, MD, PhD, University Hospital of Leipzig, Leipzig, Germany, describes the unmet needs in head and neck squamous cell carcinoma (HNSCC), highlighting the challenges in de-escalating treatment for HPV-positive and p16-positive patients, as well as the difficulties in managing advanced resectable and unresectable oral cavities and hypopharynx cancers. Ongoing trials are investigating the potential benefit of checkpoint inhibition for organ preservation in larynx and hypopharynx cancers, and various combination therapies, including cetuximab, ADCs, and bispecific antibodies, are being explored to improve outcomes in metastatic disease. This interview took place at the European Society for Medical Oncology (ESMO) 2025 Congress in Berlin, Germany.
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Transcript
There are a lot of unmet needs in head and neck carcinoma. The one I just mentioned about the HPV positives, the P16 positives. The question is really what is the best strategy to de-escalate just because the prognosis is very good and to find the right program to do that; all studies failed in that direction, so this is still probably not enough understood what to do...
There are a lot of unmet needs in head and neck carcinoma. The one I just mentioned about the HPV positives, the P16 positives. The question is really what is the best strategy to de-escalate just because the prognosis is very good and to find the right program to do that; all studies failed in that direction, so this is still probably not enough understood what to do. But a nightmare are the advanced resectable and unresectable oral cavities, P16 negative oral pharynx and larynx, and hypopharynx. So, for larynx and hypopharynx, for the advanced, it’s very interesting to learn whether checkpoint inhibition adds some benefit for organ preservation. So, there are trials running to address that. The next is what’s about metastatic disease. So, we see a lot of effort, but if there is relapse, prognosis is getting worse still. And there are a lot of conjugates, ADCs, bispecific antibodies, partners for pembro, nivo, and cetuximab, interestingly, which try to combine and to look for better outcomes in this group. Results are stimulating, but less disappointing, I would say. So, we are waiting for the great breakthrough with some good combination of different modes of action.
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