Head and Neck Squamous Cell Carcinoma: KOL Insight

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Publication Date:
March 2016
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Immunotherapies are about to transform HNSCC treatment. Can one brand corner the market?

Key opinion leaders (KOLs) say immunotherapies will transform the head and neck squamous cell carcinoma (HNSCC) landscape. But until Phase III trial results are in, there’s no consensus about where they’ll fit into the treatment algorithm—and whether any one brand can corner the market.

Find out what KOLs think in FirstWord’s new report, KOL Insight: HNSCC

You’ll learn how immunotherapies are likely to be used, and how they’ll compete with current treatments and other pipeline drugs. You’ll also get KOLs’ candid thoughts on the innovative clinical trials shaping key HNSCC treatment decisions.

View: North American KOLs and EU KOLs

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“…the current impression in the US is that everything
 will change in the immunotherapy era.”


Answering key questions

The report covers 8 pipeline HNSCC immunotherapies and targeted agents, as well as Erbitux—a current standard-of-care treatment:

EGFR Inhibitors

  • Erbitux (cetuximab; Eli Lilly/Merck): What limits the use of Erbitux in first-line HNSCC treatment?
  • Gilotrif/Giotrif (afatinib; Boehringer Ingelheim): Could Gilotrif/Giotrif potentially be used as a maintenance therapy?
  • Tarceva (erlotinib; Astellas/Roche): What factors will decide Tarceva’s future in HNSCC treatment?


  • Durvalumab (MEDI4736; AstraZeneca): Are clinical or business factors more likely to dictate durvalumab’s competitive success?
  • Keytruda (pembrolizumab; Merck & Co.): Which clinical trials are shaping KOLs’ view of Keytruda as an HNSCC treatment? 
  • Multikine (Leukocyte interleukin, CEL-SCI): What do KOLS say CEL-SCI can do to increase Multikine’s chances for success?
  • Opdivo (nivolumab; Bristol-Myers Squibb): What kind of uptake do KOLs foresee for Opdivo in recurrent/metastatic HNSCC treatment?

Other Treatments

  • Avastin (bevacizumab; Genentech/Roche: How will Avastin’s risk/benefit profile affect its potential use in HNSCC treatment?
  • Reolysin (pelareorep; Oncolytics Biotech): Why are KOLs divided about Reolysin’s prospects as an HNSCC treatment?

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Top takeaways

  • Immunotherapies will transform HNSCC treatment. The question is how? Find out where KOLs expect them to be positioned in the treatment algorithm as Phase III trial results come in.
  • Race for 1st place is on: Three pipeline checkpoint inhibitors are vying for top spot. What will it take for one brand to gain a competitive edge?
  • Bold commercial strategies: Immunotherapy manufacturers are taking bold—and very different—approaches to positioning their products. Whose will pay off?
  • Clinical trials are key: Innovative clinical trials like RTOG-1016, KEYNOTE-048, KESTREL, CheckMate-141, and others will dictate important treatment decisions. Find out how.
  • Erbitux use likely to change: KOLs see untapped opportunities for Erbitux in HNSCC treatment. Find out what they are, and whether they’ll offset competition from immunotherapies. 
  • Challenging market for New EGFR inhibitors: Can EGFR-TKIs gain a foothold in HNSCC treatment? Find out whether KOL’s think they can overcome the obstacles standing in their way.
  • Modest expectations for other approaches: KOLs see less potential for other pipeline drugs, but say that specific applications may help some of them find a niche. 
  • Early days for biomarkers: KOLs expect biomarkers to play an important role in HNSCC treatment. Learn how they view early efforts to use PD-L1 as a biomarker.

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“How to best incorporate immunotherapies
will be the key challenge for the future.”

- US Key Opinion Leader

Key issues explored

  • Unmet need: The defining characteristic of HNSCC treatment, unmet need is most acute for recurrent/metastatic and HPV-negative HNSCC.  
  • KOLs welcome immunotherapies: In an area plagued by high levels of unmet need, KOLs say immunotherapies—especially checkpoint inhibitors—offer much-needed options.
  • Commercial vs. clinical: Hear whether KOLs expect commercial or clinical factors to play a bigger role in differentiating checkpoint inhibitors.
  • First-line immunotherapies: Some manufacturers are trying to position immunotherapies as first-line treatments. Find out if KOLs think they’re likely to succeed.
  • Combination therapies: KOLs expect combination therapies to play a big role in HNSCC. Find out how that will affect treatment decisions for pipeline drugs.
  • Personalised treatment: Find out how KOLs expect biomarkers, and more segmented treatment approaches to change the HNSCC treatment paradigm.
  • Cost concerns: Some HNSCC treatments come with a high price tag. Find out which ones KOLs think are worth the cost, and what cost containment strategies they see on the horizon.

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“…we need to invest more in biomarkers in order to select the
best combination for a patient. I think this is the future.”

- EU Key Opinion Leader

A report based on expert knowledge

We interviewed 12 KOLs from North America and Europe between 10/12/2015 and 18/01/2016.

North American KOLs

  • Dimitrios Colevas, MD. Associate Professor of Medicine (Oncology) and head and neck surgery, Stanford University Medical Center, Stanford, CA. 
  • Renata Ferrarotto MD. Assistant Professor, Thoracic/Head & Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX.
  • Saad Khan, MD. Medical Oncologist and Assistant Professor in the Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX. 
  • Krzysztof Misiukiewicz MD. Assistant Professor Medicine, Hematology and Medical Oncology, Mount Sinai Hospital, New York, NY.
  • Neal Reddy, MD, PhD. Associate Professor of Medicine, Member of the Duke Cancer Institute, Duke University School of Medicine, Durham, NC. 
  • Jared Weiss, MD. Assistant Professor of Medicine for Hematology/Oncology at the University of North Carolina School of Medicine in Chapel Hill, NC.

European KOLs

  • Caroline Brammer, MD. Consultant in Clinical Oncology, The Clatterbridge Cancer Centre, Bebington, UK. 
  • Daris Ferrari, MD. Director USD Oncological Palliative Care, San Paolo Hospital, Milan, Italy.  
  • Bernie Foran. Consultant Clinical Oncologist and Honorary Senior Lecturer, Weston Park Hospital Sheffield, UK.
  • Ricard Mesia Nin, MD. Medical Oncologist, Catalan Institute of Oncology, ICO Hospital, Barcelona, Spain.
  • Anonymous German KOL, MD. Professor and Medical Oncologist, University Medical Centre, Germany. 
  • Anonymous German KOL, MD. Senior Medical Oncologist, Major University Hospital, Germany. 

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The world of pharma is ever changing and executives must always be up-to-date with new developments that could affect their own products, position and research. That is why FirstWord's guarantee to keep Therapy Trends clients up to date with Update Bulletins offers a real commercial advantage.

Update Bulletins include expert insight and analysis based on FirstWord analyst re-engagement with the KOLs after major events such as product approvals, key data releases and major conferences to deliver the most valuable insights with each update.

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