Dr. Nabil F. Saba Answers Questions About Head and Neck Cancer and Immunotherapy After the 2021 CRI Virtual Immunotherapy Patient Summit

At the CRI Virtual Immunotherapy Patient Summit in October, patients and caregivers were eager to further their understanding of immunotherapy for head and neck cancer.

Nabil F. Saba, MD, FACP, professor and vice chair for quality and safety at Emory University’s department of hematology and medical oncology and professor of otolaryngology at Emory University School of Medicine, led the Head and Neck Cancer and Immunotherapy session.

We followed up with Dr. Saba after the event to discuss several more questions from attendees.

My husband’s cancer is an extremely rare salivary gland cancer. I’ve noticed that most clinical trials are for specific cancers and don’t include rare cancers. How likely would he be able to participate in a clinical trial?

This is a major problem for rare diseases. I know that there are very few trials for saliva gland cancers. The best bet is to look at what cancer centers have a high volume of cancer patients. I am not aware of current national trials opened for saliva gland cancers. NRG Oncology is working on opening a trial for recurrent disease.

You can check clinical trials.gov or set up an appointment with one of the Cancer Research Institute’s Clinical Trial Navigators to see what is available for you.

Generally, how long are patients treated with immunotherapy? Does the length of time vary based upon the effectiveness?

A very good question. It depends on whether they have a complete response (disappearance of disease) or partial response. If they have a complete response that has lasted for two or more years, I would consider stopping at that time. However, if they have a partial response, I recommend continuing as long as they can tolerate the treatment and are willing to continue. There are no clear answers as far as an ideal time for continuing or stopping immunotherapy.

I’ve been receiving a checkpoint inhibitor for nearly three years and am interested in learning about research on maintenance treatment schedules for immunotherapy.

There is little research as far as how long to continue or stop. I have personally considered spacing the infusions for patients who have received more than two years of treatment, are in remission, and wish to continue therapy. The answer to this question needs to be tailored to each patient’s situation, so unfortunately there is no one answer for all patients.

Do you have to be an oncologist to understand which immunotherapy clinical trial to enroll in?

You probably need to consult with your cancer specialist to decide on trials that are right for you. I would consult with your disease site expert. Medical oncologists will be more likely to know about these studies as they are the ones prescribing and administering these treatments.

Does immunotherapy make lymphedema worse or cause lymphedema?

There has been a noted increase in lymphedema of the neck in patients with head and neck cancer who receive immunotherapy. However, it is unclear if this is related to previous radiation or surgery to the neck.

In general, this seems to be an infrequent occurrence with immunotherapy.

Learn more about immunotherapy for head and neck cancer