SITC Head and Neck Squamous Cell Carcinoma Immunotherapy Guideline

SITC's Cancer Immunotherapy Guidelines program is a collection of Clinical Practice Guidelines (CPGs) developed by multi-disciplinary panels of experts who draw from their own practical experience as well as evidence in the published literature and clinical trial data to develop evidence- and consensus-based recommendations. SITC uses as a model the Institute of Medicine's 2011 "Standards for Developing Trustworthy Clinical Practice Guidelines" to ensure the recommendations are unbiased, transparent, and balanced. CPGs will aid oncologists in effective clinical decision-making concerning patient selection, toxicity management, response evaluation, and the sequencing or combination of therapies, among other topics.

The head and neck squamous cell carcinoma (HNSCC) CPG was developed collaboratively through the efforts of an expert panel that convened to discuss the current therapeutic landscape. This CPG provides recommendations for FDA-approved immunotherapies for head and neck squamous cell carcinoma, as well as discussion of promising emerging treatment modalities and patient quality of life issues.

Published Guideline

read guideline

The HNSCC CPG originally published in The Journal for ImmunoTherapy of Cancer (JITC) on July 15, 2019.

SITC continuously evaluates the field for practice-changing data and new FDA approvals. When needed, the HNSCC CPG Expert Panel will guide the development of updates within this CPG. Updates will appear in the SITC CPG Mobile App and as annotated text accompanying the original publication in JITC.

Guideline Education

SITC is pleased to offer companion education resources in support of the published Head and Neck Cancer CPG. These activities feature faculty comprised of the guideline expert panel and are designed to provide a deeper understanding of the recommendations in the SITC guidelines and how to apply them in various clinical scenarios. The education available features webinars which are a longer-format recording that takes a deeper look at the guideline recommendations as well as mini-modules which are brief videos on a specific topic within the guideline content. Below is a list of the available educational resources for this CPG available free and on-demand.

Webinars:

• Immunotherapy for the Treatment of Squamous Cell Carcinoma of the Head and Neck (HNSCC)- SITC CPG Webinar
  • Leading experts in cancer immunotherapy present an overview of the publication "The Society for Immunotherapy of Cancer consensus statement on immunotherapy for the treatment of squamous cell carcinoma of the head and neck (HNSCC)."

• Practical Management Pearls for Immunotherapy for the Treatment of Head and Neck Squamous Cell Carcinoma- SITC CPG Webinar
  • This one hour on-demand webinar features members of the guideline Expert Panel. These faculty members discuss how to appraise and classify organ-specific considerations for immunotherapy agents and toxicities, identify and manage clinically significant uncommon toxicities, and determine optimal sequencing of immunotherapies in relapsed and/or refractory disease.
    

• Case Studies in Immunotherapy for the Treatment of Head and Neck Squamous Cell Carcinoma- SITC CPG Webinar
  • This one hour on-demand webinar features members of the guideline Expert Panel. These faculty members discuss case studies that illustrate execution of SITC guideline recommendations, as well as discussion on difficult topics related to case management. 
    

Mini-Modules:

• Identifying Pseudoprogression and Managing Disease Unresponsive to Immunotherapy
  • Features a case presentation on a patient with recurrent HNSCC in the oropharynx and lungs. Panelists use this case as a starting point to discuss the incidence of pseudoprogresson during immunotherapy of HNSCC, risks and benefits of transitioning patients from immunotherapy to chemotherapy, and distinguishing between pseudoprogression and unresponsive tumors.

• Risks and Benefits of Immunotherapy Combination Therapies to Treat Oligometastatic Disease
  • Panelists compare the risks and benefits of combining local therapy with systemic immunotherapy to the risks and benefits of local therapy alone to treat recurrent head and neck squamous cell carcinoma (HNSCC) in patients who test positive for HPV. Discusses the sequencing of immunotherapy with stereotactic body radiotherapy (SBRT) to treat oligometastatic disease, emerging immunotherapy combinations, intratumoral treatments, and the future of combination therapy for HNSCC.

• Selecting Appropriate Treatment Strategies for Recurrent/Metastatic HNSCC
  • Presents the case of a 63-year-old man with metastatic squamous cell carcinoma (SCC), two years after undergoing a resection of the tongue.  Addresses the current standard of care of SCC and the roles of PD-L1 testing when planning treatment for SCC.  Insights from KEYNOTE-048 clinical trial, which compared the efficacies of immunotherapy, an immunotherapy/chemotherapy combination, and the EXTREME regimen for treatment of recurrent/metastatic HNSCC are also provided.  Concludes with a panel discussion about important factors to consider when planning treatment for patients with recurrent/metastatic HNSCC.