Checkpoint Inhibitor Immunotherapy for Head and Neck Cancer: Incorporating Care Step Pathways for Effective...

Area of Science:

• Oncology
• Immunology

Background:

• Immunotherapy, specifically immune checkpoint inhibitors targeting programmed cell death protein 1 (PD-1), has become a significant treatment for recurrent/metastatic head and neck squamous cell carcinoma (HNSCC) since 2016.
• Pembrolizumab and nivolumab are FDA-approved for HNSCC patients progressing on platinum-based chemotherapy, demonstrating clinical activity.
• These immunotherapies can induce unique immune-related adverse events (irAEs) that pose management challenges for healthcare providers.

Purpose of the Study:

• To highlight the critical role of advanced practice providers (APPs) in managing irAEs associated with immunotherapy in HNSCC.
• To summarize Care Step Pathways (CSPs) for diagnosing and managing specific irAEs relevant to HNSCC patients.
• To emphasize the educational and supportive role of APPs for both patients and other healthcare professionals.

Main Methods:

• Review and summarization of Care Step Pathways (CSPs) developed by the Immuno-Oncology Essentials initiative.
• Focus on irAEs including thyroiditis, mucositis/xerostomia, skin toxicities, and hepatotoxicity.
• Consideration of the specific needs of the head and neck squamous cell carcinoma patient population.

Main Results:

• APPs possess vital experience in managing irAEs, contributing significantly to patient care teams.
• Early experience with immunotherapy allows APPs to effectively educate and support patients and colleagues.
• CSPs provide valuable tools for the diagnosis and management of common irAEs.

Conclusions:

• Advanced practice providers are essential members of the care team for HNSCC patients receiving immunotherapy.
• Effective management of immunotherapy-induced irAEs is crucial for patient outcomes.
• Utilizing resources like CSPs can improve the identification and treatment of irAEs in HNSCC.