Question about Head and Neck Cancers and Immunotherapy

[Alakazam123]

In my cancer immunology class, we discussed immunotherapies for various head and neck cancers. We had a surgical oncologist come in and talk about his work as well. What I'm curious about is, how will immunotherapies affect surgical treatment of H&N cancers? Will it render surgical intervention obsolete or will it help surgeons more easily resect the tumors?

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[Goro]

In my cancer immunology class, we discussed immunotherapies for various head and neck cancers. We had a surgical oncologist come in and talk about his work as well. What I'm curious about is, how will immunotherapies affect surgical treatment of H&N cancers? Will it render surgical intervention obsolete or will it help surgeons more easily resect the tumors?

Neither. Surgery and other tumor ablatives de-bulk the tumors; immunotherapies kill off any remaining cancer cells.

 

[Alakazam123]

Neither. Surgery and other tumor ablatives de-bulk the tumors; immunotherapies kill off any remaining cancer cells.

Thank you!! What prevents Immunotherapy from "de-bulking" the tumor. Also, I've been very curious about this, which specialty of medicine do you practice?

 

[RinShanKaiHo]

I don't think they use immunotherapy as neoadjuvant in H&N tumours. I might not be the most informed person though. The best way to learn more about this is: send the surgical oncologist an email :/

 

[Goro]

Thank you!! What prevents Immunotherapy from "de-bulking" the tumor. Also, I've been very curious about this, which specialty of medicine do you practice?

PhD, Not MD/DO.

I have done some Ca research, hence my knowledge of the field, which is peripheral to mine.

Tumors are hard for antibodies to get into (imagine trying to dissolve an avocado pit from the outside).

The immune cells that get into the tumor (they KNOW that there's something wrong!) are not active enough to kill the tumor from the inside, or the tumors have mechanisms that prevent the cells from working.

Some Immunotherapies rev up those cells to turn them into super killers, others, like the checkpoint inhibitors, remove the roadblocks to tumors killing.

 

[GoSpursGo]

Moving to pre-med.

Agree you should reach out to the surgeon directly.

However, nothing is going to render surgery "obsolete." Almost every solid tumor is thought of in terms of local control (surgery vs. radiation) and, for sensitive tumors, systemic therapy (chemo or immunotherapy) to treat metastatic or micrometastatic disease. Importantly, depending on tumor type, only 20-50% of patients are going to respond to immunotherapy at all.