Chemotherapy is a treatment for head and neck cancer that uses powerful drugs to attack cancer cells. Often chemotherapy drugs are given before or during radiation to improve the effectiveness of care. Other drug therapies target the genetic mutations found in tumors or stimulate the immune system to fight the cancer.

At Memorial Sloan Kettering, our patients receive chemotherapy and other drug therapies from head and neck cancer experts who specialize solely in caring for people with head and neck cancer. Our medical oncologists (the doctors who treat cancer using drug therapies) work with you to create a customized treatment plan that fits your needs and leads to the best possible outcome for you.

MSK’s medical oncologists bring extraordinary skill to caring for people with advanced head and neck cancer. We have deep knowledge of the newest head and neck clinical trials. These studies may give you access to advanced therapies years before they’re available elsewhere. Our recommendations are often based on the results of genetic testing.

We place a high value on the concept that less is more. We tailor therapy to each person’s individual circumstances. For example, MSK’s medical oncologists sometimes advise against chemotherapy for people with head and neck cancer when the benefits are not clear and the side effects would be significant.

Here, you can find an overview of how drug therapies are used to fight head and neck cancer, as well as information on MSK’s particular expertise.

Chemoradiation for Head and Neck Cancer

Sometimes your doctor will recommend chemotherapy as part of your radiation therapy because it can increase the tumor’s sensitivity to treatment. The combination of radiation plus chemotherapy is called chemoradiation.

Cisplatin (Platinol^®) is the standard chemotherapy drug that doctors recommend as part of chemoradiation. At MSK, our researchers are studying other drugs that may be used in combination with radiation to further reduce the risk of the cancer returning.

Immunotherapy for Head and Neck Cancer

Drugs that empower the immune system to recognize and fight cancer have proven to be a very effective way to treat advanced melanoma and lung cancer, among other cancers. MSK has been a pioneer in developing this approach, known as immunotherapy.

In 2016, the FDA approved two checkpoint inhibitors for squamous cell head and neck cancer that has stopped responding to standard chemotherapy. The drugs are called nivolumab (Opdivo^®) and pembrolizumab (Keytruda^®).

Both of these medications block a protein called PD-1 found on immune cells. PD-1 acts like a brake on the immune system, tamping down immune responses. Nivolumab and pembrolizumab release this brake, allowing the immune system to mount a stronger attack against cancer.

This approach doesn’t work for everyone, though. At MSK, we are studying how immunotherapy can help more people with head and neck cancer. For example, we are running clinical trials to test immunotherapies in combination with other treatments, such as traditional chemotherapy drugs as well as radiation therapy.

We are also exploring the use of immunotherapy before surgery for people with aggressive head and neck cancer. We are trying to learn if this reduces the chances that the cancer will come back after initial treatment.

MSK patients may be eligible to enroll in these and other clinical trials testing promising new approaches for head and neck cancer treatment.

Targeted Therapy for Head and Neck Cancer

Traditional chemotherapy works by going after rapidly dividing cells in the body. Targeted therapies are a newer form of drug therapy. They allow doctors to tailor treatments to the specific genetic differences found in an individual tumor.

These genetic changes are identified using a technology called genomic testing. Genomic testing is also called tumor sequencing or molecular profiling. It involves looking at the cells taken from a tumor to see if there are any genetic mutations (changes in the genes) that could be linked to the tumor.

Genomic testing can help our doctors personalize your care. We can rule out drug therapies that may not work for you. In some cases, you may be able to join a cutting-edge clinical trial of targeted therapies.

MSK is a world leader in the field of genomic testing. In fact, our researchers developed a highly sophisticated testing approach called MSK-IMPACT™. This test is helping pave the way to new drug therapies for head and neck cancer.

For example, using MSK-IMPACT, our researchers have determined that approximately 13 percent of head and neck cancers have a mutation in the PIK3CA gene. The percentage is even higher in tumors related to human papillomavirus (HPV) infection. We are currently exploring new approaches targeting that mutation. Our researchers have also identified genetic mutations associated with adenoid cystic carcinoma, a type of salivary gland cancer.

Why choose to have chemotherapy at Memorial Sloan Kettering?

• In order to treat head and neck cancer in the best possible way, it takes a dedicated team of doctors, nurses, and quality-of-life experts. Our head and neck cancer team is one of the largest and most experienced in the country.
• We take a personalized approach to head and neck cancer care. We tailor the selection of chemotherapy drugs to those that are best suited to you. We find the best ways to integrate those drugs into your overall care plan.
• Our goal is not just to cure or control the cancer but to ensure that each person who comes to MSK for care has the best possible quality of life. That’s why our medical oncologists consider many details. These include whether the cancer is linked to HPV or tobacco use, the genetic makeup of the tumor, the likelihood that the cancer could spread to other places in the body, and other medical information that could lead us to recommend one approach over another. Sometimes we recommend no chemotherapy as part of a personalized approach.