Head and Neck cancer is among the most common cancers worldwide, with a high prevalence in south East Asia, Brazil and central Europe. Head and Neck Squamous cell carcinoma (HNSCC) is associated with elevated mutational load but lacks specific genetic mutations. Exposure to carcinogens including tobacco and alcohol are the most dominant etiologic factors of HNSCC, while Epstein-Barr (HBV) and Human Papilloma Viruses (HPV) are associated with nasopharyngeal and oropharyngeal carcinoma, respectively. Surgery including open and minimally invasive procedures is considered the standard of care for the majority of oral cavity and early larynx cancers, while radiation therapy or concurrent chemoradiation are used for the other head and neck cancers. The treatment of patients with head and neck cancer is complex and has undergone considerable transformation in the last decade. These modalities include immunotherapy, targeted therapy (small molecule inhibitors or antibodies), or combined modality treatments. Emerging evidence supports a vital role of the immune system in eradicating HNSCC. Cancer cells express programmed death ligand 1 or 2 (PD-L1/2) which binds to the PD receptor on the T-cell, leading to an inactivation of the cytotoxic response of the T-cell. Cytotoxic T lymphocytes antigen-4 (CTLA-4) is another key player, expressed by cancer-activated T-cells, which binds to B7 ligand on the cancer cells, leading to inhibition of T-cells activation. Checkpoint inhibitors such as anti-PD-1 and anti-PD-L1 antibodies, were shown to significantly improve disease free survival and overall survival after failure of platinum-based chemotherapy. In addition, expression of HPV is associated with better response to single modality treatment (e.g. radiotherapy or surgery) and improved survival. In future years we expect to see the establishment of precision medicine modalities in an attempt to extend survival and improve quality of life of advanced stage HNSCC patients. Several phase III clinical trials are in progress to evaluate the utility of checkpoint inhibitors at different treatment settings, including combinations with adjuvant surgery, radiation therapy and chemotherapy.

头颈癌是全球最常见的癌症之一，在东南亚，巴西和中欧的患病率很高。头颈部鳞状细胞癌（HNSCC）与突变负荷增加有关，但缺乏特定的基因突变。暴露于包括烟草和酒精在内的致癌物是HNSCC的最主要病因，而爱泼斯坦-巴尔（HBV）和人乳头瘤病毒（HPV）分别与鼻咽癌和口咽癌相关。包括开放式和微创手术在内的手术被认为是大多数口腔癌和早期喉癌的护理标准，而其他头颈癌则采用放射疗法或同时放化疗。头颈癌患者的治疗很复杂，并且在过去十年中经历了相当大的转变。这些方式包括免疫疗法，靶向疗法（小分子抑制剂或抗体）或联合疗法。新兴证据支持免疫系统在根除HNSCC中的重要作用。癌细胞表达与T细胞上PD受体结合的程序性死亡配体1或2（PD-L1 / 2），从而导致T细胞的细胞毒性反应失活。细胞毒性T淋巴细胞抗原4（CTLA-4）是由癌症激活的T细胞表达的另一个关键角色，该T细胞与癌细胞上的B7配体结合，从而抑制T细胞激活。检查点抑制剂，例如抗PD-1和抗PD-L1抗体，研究表明，铂类化学疗法失败后，它们可以显着改善无病生存期和总体生存期。此外，HPV的表达与对单模治疗（例如放射疗法或手术）的更好反应和改善的生存率相关。在未来的几年中，我们希望看到建立精确的医学方法，以期延长晚期HNSCC患者的生存率并改善其生活质量。正在进行多项III期临床试验，以评估检查点抑制剂在不同治疗设置下的效用，包括与辅助手术，放射疗法和化学疗法的组合。放射疗法或手术）和提高生存率。在未来的几年中，我们希望看到建立精确的医学方法，以期延长晚期HNSCC患者的生存率并改善其生活质量。正在进行多项III期临床试验，以评估检查点抑制剂在不同治疗设置下的效用，包括与辅助手术，放射疗法和化学疗法的组合。放射疗法或手术）和提高生存率。在未来的几年中，我们希望看到建立精确的医学方法，以期延长晚期HNSCC患者的生存率并改善其生活质量。正在进行多项III期临床试验，以评估检查点抑制剂在不同治疗设置下的效用，包括与辅助手术，放射疗法和化学疗法的组合。