Head and Neck Squamous Cell Carcinoma
HNSCC at a glance
Head and neck squamous cell carcinoma (HNSCC) is the seventh most common cancer worldwide, and accounts for 3% of all malignancies.1 These epithelial tumors are derived from the mucosal lining of the oral cavity, oropharynx, larynx, or hypopharynx—and is the most common malignancy that arises from the head and neck.1-3
According to the GLOBOCAN (global cancer statistics) 2018 report, >800,000 new HNSCC cases are diagnosed each year with the incidence expected to increase by 30% (1.08 million annual cases) in 2030.2,4 Last 2021, there were >50,000 new cases and 10,850 deaths due to HNSCC in the United States alone.5
In general, the five-year survival rate for HNSCC is about 67%. This rate may vary according to the disease stage at diagnosis, with five-year survival rates of 82.2% for localized disease, 67.9% for regional metastatic disease, and 40.2% for distal metastatic disease.5
Developments in HNSCC treatment
For localized HNSCC, the standard of care primarily consists of a surgical approach followed by radiation and adjuvant chemotherapy.1,4 This is often the procedure recommended for tumors of the oral cavity and advanced tumors of the larynx and hypopharynx when functional preservation is not feasible.1 In patients with localized disease with no clinical node involvement, or with only a single node involved, cure rates of over 80% have been achieved by surgery alone.4
Despite the high cure rate for standard of care surgery, about 17-31% of these patients eventually undergo further radiation therapy and/or adjuvant chemotherapy due to disease recurrence.1 For high-risk patients with post-surgical extra-nodal extension, close surgical margins, perineural invasion, or poor candidates for surgical management, chemoradiotherapy with single-agent cisplatin is recommended.1,4 For recurrent, unresectable, or metastatic disease with no surgical or radiotherapy options, the preferred first-line regimens include pembrolizumab for tumors that express PD-L1 with combined positive score ≥1, and pembrolizumab with platinum (cisplatin or carboplatin) and 5-fluorouracil.6 Aside from pharmacological therapy, multidisciplinary and holistic care should be included as part of a patient’s treatment plan.4
Muzaffar J, et al. Cancers. 2021;13(2):338.
Canning M, et al. Front Cell Dev Biol. 2019;7:52.
Economopoulou P, et al. Front Oncol. 2019;9:827.
Johnson DE, et al. Nat Rev Dis Primers. 2020;6(1):1-22.
National Cancer Institute. Surveillance, Epidemiology, and End Results Program. https://seer.cancer.gov/statfacts/html/oralcav.html (Accessed: January 2023).
National Comprehensive Cancer Network. NCCN Guidelines: Soft Tissue Sarcoma, Version 3.2024. https://www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf (Accessed: March 2024).