Eligibility for Photoimmunotherapy in Patients with Unresectable Advanced or Recurrent Head and Neck Cancer and Changes before and after Systemic Therapy

SIMPLE SUMMARY: Photoimmunotherapy is a novel cancer treatment that recently became covered by national health insurance only in Japan. We investigated the characteristics of patients with head and neck cancer who can, potentially can, and cannot be treated with photoimmunotherapy (eligible, potentially eligible, and ineligible, respectively). We retrospectively reviewed the medical records of 246 patients who started receiving systemic therapy for advanced or recurrent head and neck cancer. After exclusions, 194 patients were evaluated, of whom 108 were ineligible for photoimmunotherapy. Eight patients were potentially eligible but ultimately not suitable candidates for photoimmunotherapy. The remaining nine patients were considered eligible. Of the nine eligible patients who received first-line systemic therapy, four became ineligible for photoimmunotherapy due to disease progression. Appropriately selected patients with advanced head and neck cancer are candidates for photoimmunotherapy, and this study contributes to deciding the strategy and timing of treatment for these patients. ABSTRACT: Photoimmunotherapy is a novel cancer treatment that recently became covered by national health insurance in Japan, but treatment decision-making remains challenging for unresectable advanced or recurrent head and neck cancer. We aimed to clarify the characteristics of patients for whom photoimmunotherapy was indicated by a retrospective chart review. Patients aged ≥20 years diagnosed with advanced or recurrent head and neck cancer who started receiving systemic therapy at the National Cancer Center Hospital East from January 2016 through December 2020 were retrospectively analyzed. Before and after first-line systemic therapy, patients were classified into 3 groups according to eligibility for photoimmunotherapy: eligible, potentially eligible, and ineligible. In total, of 246 patients evaluated—194 after exclusions were analyzed—108 were deemed ineligible for treatment. Of the remaining 86 patients, 8 were considered potentially eligible and 9 eligible. Of the nine eligible patients, four became ineligible after receiving first-line systemic therapy due to disease progression. Our results suggest that the indication of photoimmunotherapy should be considered before, during, and after systemic therapy for unresectable locally advanced or recurrent head and neck cancer.