Immunotherapy for Head and Neck Cancer

Head and neck cancer can begin in the nasal passages, oral cavity, sinuses, throat or voice box (larynx). Most tumors originate in the thin, flat squamous cells that line the mucosal surfaces of the head and neck. The primary risk factors are heavy alcohol consumption, persistent human papillomavirus (HPV) infection and tobacco use, but certain occupational hazards, poor nutrition and sun exposure can also play a role. Head and neck cancer is most often found in adults older than 40, but it can affect anyone.

The warning signs of head and neck cancer can vary depending on where the tumor develops. Common symptoms include a sore in the mouth that does not heal, difficulty swallowing, ear pain, persistent vocal hoarseness and swelling in the neck. The diagnostic process typically involves a physical examination, imaging studies and a tissue biopsy to confirm the presence of cancerous cells. Based on the type, stage and location of the tumor, treatment options may include surgery, radiation therapy, chemotherapy, targeted therapy and/or immunotherapy.

Head and neck cancer accounts for approximately 4% percent of all cancers in the United States, making it a relatively uncommon but still significant health concern. Early detection and new treatment approaches, such as immunotherapy, continue to improve outcomes and quality of life for many patients. Due to the critical location of many head and neck tumors, treatment can sometimes affect the patient’s ability to eat, swallow or breathe. Immunotherapy is a promising treatment option that can help some patients avoid these complications.

“Every day that I was at Moffitt, I always came home enriched.  You get to the point where you don’t want to leave because you just feel like it’s home.”  

Ellen, neck and thyroid cancer survivor

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What does immunotherapy for head and neck cancer involve?

Immunotherapy is a cancer treatment that harnesses the power of the body’s own immune system to recognize and destroy tumor cells. Usually, the medications are administered through an intravenous (IV) infusion on a regular schedule, which may continue for several months. Immunotherapy may be given as a stand-alone treatment or in combination with other therapies, such as chemotherapy, radiation therapy and/or targeted therapy, depending on the stage of the tumor and how well the patient has responded to earlier treatments. In some cases, this approach offers the possibility of longer-lasting cancer control compared to traditional therapies alone.

For head and neck cancer, the most common form of immunotherapy involves the use of immune checkpoint inhibitors. Known as monoclonal antibodies, these specialized medications are designed to target specific proteins, such as PD-1 and PD-L1, which tumor cells use to evade detection by the immune system. Normally, these proteins act as “brakes” on the immune response, preventing it from attacking healthy cells. However, many cancer cells can exploit this pathway by overproducing PD-L1, which binds to the PD-1 receptors on certain immune cells (T-cells) and shuts down their activity. By blocking these signals, checkpoint inhibitors can effectively “release the brakes,” allowing the T-cells to remain active, recognize cancer cells as abnormal and mount a stronger, more sustained attack against the tumor.

Additionally, adoptive cell therapies (ACT) for head and neck cancer, including tumor-infiltrating lymphocytes (TILs) and chimeric antigen receptor (CAR) T-cells, are currently under active study. While these treatments are still largely in the clinical trial phase and not yet standard of care, early research has shown that TIL therapy in particular may help stabilize advanced head and neck cancer in some patients who have not responded to conventional treatments. Although significant challenges remain—such as the complex tumor microenvironment and the difficulty of applying CAR-T therapy to solid tumors—ongoing studies continue to demonstrate potential for improving outcomes in select patients.

What are the risks and possible complications of immunotherapy for head and neck cancer?

Because immunotherapy works by stimulating the immune system, it can sometimes cause an overly robust immune response that affects healthy cells. This can lead to a variety of side effects, such as coughing, diarrhea, fatigue, skin rash and inflammation of the colon, liver, lungs or thyroid. While most side effects are mild and manageable, some may become more serious if left untreated. While receiving immunotherapy, the patient will be closely monitored so that any complications can be addressed quickly with corticosteroids or other supportive medications.

What to expect during recovery from immunotherapy for head and neck cancer

Recovery from immunotherapy is often less demanding than recovery from chemotherapy or radiation therapy. Many patients tolerate the treatment well and can maintain their normal daily routine, although fatigue is common. Because some side effects may appear weeks or even months after immunotherapy begins, consistent follow-up care is important. Most side effects improve once therapy is complete, but certain immune-related conditions may require ongoing management. Periodic medical checkups, lab tests and imaging scans can allow the physician to track both the effectiveness of the treatment and the patient’s overall recovery.

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How effective is immunotherapy for head and neck cancer?

Immunotherapy has provided meaningful benefits for some patients with head and neck cancer, particularly those with recurrent or metastatic cancer that has not responded to standard treatments. In certain cases, it has achieved durable tumor control, an important advancement over traditional therapies alone. While immunotherapy is not suitable or effective for every patient, it can slow cancer progression and improve quality of life for many. Continued research is expanding its role in the treatment of head and neck cancer, offering hope for better outcomes in a growing number of patients.

Benefit from world-class care at Moffitt Cancer Center

The scientists and clinicians at Moffitt are making great strides in advancing the treatment of head and neck cancer, and we continue to explore and develop novel cellular immunotherapies and other treatment options. If you would like to learn more about immunotherapy, you can request an appointment with a specialist in our Head and Neck Cancer Program by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.