Neoadjuvant Immunotherapy Strategies in HPV-Related Head-and-Neck Cancer

Purpose of Review Herein, we review current evidence and future directions of neoadjuvant immunotherapy in HPV-related head-and-neck squamous cell carcinoma (HNSCC) by describing published data and ongoing clinical trials. Recent Findings Although HNSCCs have shown response to immune checkpoint inhibitors in recurrent/metastatic disease, a limited number of patients benefit from this treatment. There is an expanding interest in clarifying the clinical benefit of immunotherapy in earlier stage disease setting including at initial presentation. Neoadjuvant immunotherapy for HPV-related HNSCCs represents a rational approach, as these cancers bear strong viral antigens. The majority of patients with HPV-related HNSCC have good prognosis, and treatment de-intensification strategies are under evaluation to decrease toxicity and maintain efficacy. On the other hand, a subset of patients with HPV-related HNSCC have a poorer prognosis, and additional treatment options are needed to improve outcome. Multiple clinical trials are ongoing to evaluate whether neoadjuvant immunotherapy will achieve these goals.