Have you ever heard of PD-L1? The National Cancer Institute explains that PD-L1 is a protein which acts as somewhat of a “brake” for immune response. Sometimes, cancer cells will express high levels of PD-L1; when these bind to another protein called PD-1, it can help protect cancer cells from being killed. However, researchers believe that measuring PD-L1 could help create more personalized treatment plans for those with head and neck cancer.

According to Medical XPress, both chemotherapy and immunotherapy are used to treat head and neck cancer. However, researchers have found it difficult to identify and predict which patients may respond well to either immunotherapy, chemotherapy, or both treatments in conjunction. In a study performed by The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust, researchers provided deeper insight into understanding how patients might respond.

Interested in learning more? The full findings can be found in the Journal of Clinical Oncology. 

The Study

Within this particular study, researchers evaluated data from the KEYNOTE-048 clinical trial. Altogether, 882 patients enrolled. During the trial, researchers evaluated the efficacy of chemotherapy and/or pembrolizumab (an immunotherapy) for those with head and neck cancer. Findings include:

• 373 patients (44.3%) had a PD-L1 score between 1-19. 
• For those with moderate PD-L1 scores, either chemotherapy OR pembrolizumab as a monotherapy was effective in preventing tumor growth and cancer progression. Using these in conjunction also helps to improve survival rates. 
• Those with low PD-L1 levels should either receive chemotherapy or chemotherapy and cetuximab, but pembrolizumab will most likely be less effective. 
• Pembrolizumab as a monotherapy is most helpful in those with high PD-L1. In fact, at least one patient from the study who had high (20+) PD-L1 levels is now in remission following pembrolizumab therapy. 

While more research is needed, researchers believe that PD-L1 testing could help improve and personalize treatments, and overall benefit patient outcomes. 

What is Head and Neck Cancer?

The National Cancer Institute explains that head and neck cancers:

Usually begin in the squamous cells that line the mucosal surfaces of the head and neck (for example, those inside the mouth, throat, and voice box) [and] are referred to as squamous cell carcinoma of the head and neck. Head and neck cancers can also begin in the salivary glands, sinuses, or muscles or nerves in the head and neck. 

Alcohol and tobacco use, HPV infection, Epstein-Barr virus infection, and radiation exposure are all associated with the development of these cancers. Symptoms vary based on the type of cancer. Some symptoms may include:

• A lump in the neck
• Sore throat
• Difficulty swallowing and/or painful swallowing
• Tinnitus (ringing in the ears)
• Difficulty hearing
• Blocked sinuses and/or frequent sinus infections
• Hoarseness
• A painful sore in the mouth or throat that does not heal
• Unusual bleeding or mouth pain
• Nosebleeds
• Difficulty breathing or speaking