Les cancers des voies aériennes et digestives supérieures à l’ère de l’immunothérapie: rationnels et spécificités de prise en charge

Head and neck squamous cell carcinoma (HNSCC) are common for men with a poor prognosis in case of recurrent or metastatic disease. There are several rationales for the use of immunotherapies in this indication. Indeed, human papilloma virus-related cancers are particularly immunogenic and provide many interesting therapeutic targets. The vaccination, as developed in cervical cancer, may be very effective in the prevention of HNSCC dysplasia. There is currently no data for curative vaccination. The rapid immune checkpoints inhibitors development in other cancers seem to arise in HNSCC also. Some trials are recruiting to evaluate anti-PD-1 in association with chemoradiotherapy for advanced tumors. In recurrent or metastatic HNSCC, the results presented in international meetings are overwhelmingly in favor of nivolumab with a significative improvement of overall survival in second line of treatment. The association with cetuximab is also studied but the skin toxicity seems to be limiting.