Immunotherapy for oropharyngeal cancer

Immunotherapy is sometimes used to treat oropharyngeal cancer. Immunotherapy helps to strengthen or restore the immune system's ability to fight cancer. Immunotherapy is sometimes called biological therapy.

The immune system normally stops itself from attaching normal cells in the body by using specific proteins called checkpoints, which are made by some immune system cells. PD-1 is an immune checkpoint protein that stops T-cells from attaching other cells in the body. It does this by attaching to PD-L1, a protein found on some normal cells and some cancer cells.

Checkpoint inhibitor drugs may target either PD-1 or PD-L1 proteins.

The following PD-1 and PD-L1 checkpoint immunotherapy drugs may be used to treat oropharyngeal cancer that has come back (recurred) or that has spread to other parts of the body (metastatic):

Pembrolizumab (Keytruda) may be used as a first-line therapy to treat metastatic or unresectable recurrent oropharyngeal cancer, with or without chemotherapy.

Nivolumab (Opdivo) is used to treat metastatic or recurrent oropharyngeal cancer that has stopped responding to chemotherapy with platinum drugs such as cisplatin or carboplatin.

Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of immunotherapy. You may also receive other treatments.

Side effects

Side effects can happen with any type of treatment for oropharyngeal cancer, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.

Side effects of immunotherapy will depend mainly on the type of drug or drug combination, the dose, how it’s given and your overall health. Nivolumab may cause these side effects:

Report side effects

Be sure to report side effects to the healthcare team. Side effects can happen any time during, immediately after or a few days or weeks after immunotherapy. Sometimes late side effects develop months or years later. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Your healthcare team is there to help. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Information about specific cancer drugs

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.

Questions to ask about immunotherapy

Find out more about immunotherapy. To make the decisions that are right for you, ask your healthcare team questions about immunotherapy.

Expert review and references

  • Machiels JP, Leemans CR, & Golusinski W. Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx: EHNS-ESMO-ESTRO clinical practices guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2020: 31(11): 146201475.
  • Mierzwa ML, Casper KA, Swiecicki PL. Oropharynx cancer. DeVita VT Jr, Lawrence TS, Rosenberg S. eds. DeVita Hellman and Rosenberg's Cancer: Principles and Practice of Oncology. 12th ed. Philadelphia, PA: Wolters Kluwer; 2023: Kindle version, chapter 26, https://read.amazon.ca/?asin=B0BG3DPT4Q&language=en-CA.
  • National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancer Version 2.2023. 2023. https://www.nccn.org/guidelines/category_1.
  • PDQ® Adult Treatment Editorial Board. Oropharyngeal Cancer Treatment (Adult) (PDQ®) – Health Professional. Bethesda, MD: National Cancer Institute; 2023. https://www.cancer.gov/.

Medical disclaimer

The information that the Canadian Cancer Society provides does not replace your relationship with your doctor. The information is for your general use, so be sure to talk to a qualified healthcare professional before making medical decisions or if you have questions about your health.

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