The patient achieved a dramatic response that was maintained 6 months after he started the drug. This was a patient who would have died of this disease by now. This is not a unique case as we’re seeing this in other cancer types as well, such as salivary gland cancer, non–small cell lung cancer, and sarcomas. This dramatically tells us that we are in a different era in cancer therapy. We are in the age where we need to understand the tumor at a molecular level, find out what's driving it, and hit those drivers. When we do, we see dramatic effects.
What are the main challenges and unmet needs for patients with head and neck cancer?
There are more than a few unmet needs in head and neck cancer. When we think about the different cancer types, we realize that it is important to understand and individualize therapy for the patients.
In broad terms, the challenge that remains for all head and neck cancers is the desire to cure the patient. In head and neck cancer, we are fortunate to be discussing cure with curative intent therapy, particularly for locally advanced squamous cell carcinoma, salivary gland cancer, and thyroid cancer.
There is a challenge to preserve the quality of life of the individual. For local events, such as squamous cell carcinoma in the HPV-positive area, we're curing more patients; however, we are also seeing more patients who are suffering the long-term morbidities of surgery, radiation, and chemotherapy.
We're trying to cure patients at a higher rate. We're hopefully going to achieve that with immunotherapy and other new agents, but we need to realize that the function that comprises the organs of the head and neck, such as our ability to speak, swallow, and interact as humans, is so critical that the quality of life is almost as important as life itself in this disease.
Do you have any advice in terms of multidisciplinary teams or palliative care?
For head and neck cancer, data clearly state that patients do better when there is a multidisciplinary team in place. What does that mean exactly? It's not just having the list of names and their specialties, but it is having them interact at a multidisciplinary tumor board.
There is evidence to suggest that patients who are [treated] in a multidisciplinary tumor board have better outcomes. Having the right people in place who are dedicated to treating the patient in a comprehensive and collaborative way at the beginning is how we can achieve the best outcome, whether it is with surgery, radiation, chemotherapy, better nutrition, getting speech and swallow exercises, dentistry, or the many other healthcare disciplines in line.
What do you think is particularly exciting about this State of the Science SummitTM?
This program illustrates what we are trying to do in head and neck cancer and thyroid cancer. We are trying to bring different people together with different disciplines—each with their area of expertise. It’s important to begin a dialog to share ideas for how different specialties interact and learn from each other. We can review the field in a comprehensive way with people who are among the best in the world at what they do.
Is there anything else you're working on right now or that you find particularly exciting in the field?
What I find the most exciting in the field are clinical trials. At UC San Diego, we have a lot of clinical trials for patients with head and neck cancer. We have a very deep interest in immunotherapy and many of our studies are geared toward that.
One of the things that we will be seeing in the future is precision immunotherapy. That means understanding the tumor at a molecular level, what the mutations are that create antigens for the immune system, and understanding the individual’s immune system and what they are most likely to respond to. We can create personalized approaches that should be much more effective than what we have today.
Those approaches will be combined with other types of immunotherapies that stimulate T cells. The core of taking those big steps forward is going to be that the personalized or precision approach might be in personalized vaccines or cellular therapies that are specifically engineered for that specific tumor.