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ICHNO-ECHNO 2022 | Challenges of combining SOC chemotherapy/radiotherapy and immunotherapy in head and neck cancer

Kevin Harrington, FRCP, FRCR, FRSB, PhD, The Institute of Cancer Research and Royal Marsden Hospital, London, UK, discusses the difficulties of using immunotherapy alongside standard-of-care (SOC) treatments of chemotherapy and radiotherapy for head and neck cancer. The randomised, phase III Javelin 100 trial (NCT02952586), investigated the use of avelumab in the lead-in phase, during SOC chemoradiation treatment, and in the adjuvant setting for 12 months. The trial did not report a significant improvement in progression-free survival (PFS) or overall survival (OS) compared to SOC chemoradiation therapy alone. The randomised phase III REACH trial (NCT02999087) studied the use of radiotherapy plus avelumab plus cetuximab in both platinum-eligible and platinum-ineligible patients. This combination therapy was compared to SOC platinum radiation therapy in platinum-eligible patients, and to SOC radiation therapy plus cetuximab in platinum-ineligible patients. The results showed no significant benefit with the addition of immunotherapy to radiotherapy. Prof. Harrington also discusses some of the main unanswered questions in this field, including treatment schedules, the volume of tissue to be irradiated, and the optimum dose-per-fraction. This interview took place at the joint International Congress on Innovative Approaches in Head and Neck Oncology and the European Congress on Head and Neck Oncology (ICHNO-ECHNO) 2022 hybrid meeting in Brussels, Belgium.