New trends in supportive care of head and neck cancers

Supportive care plays a vital role in the management of head and neck cancer (HNC) patients, as the disease often affects a frail and older population that is treated with multiple strategies and is associated with severe symptoms. We will focus on mucositis, dermatitis, dysphagia, pain, cachexia, and infections, as they are among the most common and challenging symptoms encountered.

Efforts have focused on multiomics approaches to decipher the complex biological pathways that drive symptom onset and treatment-related toxicities, with the aim of developing novel therapeutic strategies. A notable example is ponsegromab, a monoclonal antibody designed to target cancer cachexia. Other promising areas of research, such as machine-learning models and the role of oral and gut microbiota on cachexia and mucositis, are actively being explored; however, their impact to date remains limited.

In recent years, new knowledge has emerged regarding the underlying causes and predictive models for the supportive care of HNC patients. Unfortunately, this expanding body of knowledge primarily adds to complexity without translating into practical applications or substantial improvements for patients. Future efforts should prioritize the standardization of therapeutic algorithms, and the generation of robust evidence based on existing preclinical models.