Head and neck squamous cell carcinoma is the sixth most common cancer, and its incidence is rising. The term head and neck cancer (HNC) comprises a number of malignancies that usually begin in the squamous cells that line the moist, mucosal surfaces inside the head and neck. These cancers develop inside the mouth, nose and throat. The annual incidence of head and neck cancers worldwide is more than 550,000 cases, with around 300,000 related deaths. Peak incidence occurs between the ages of 55 and 64.
The HNC market is characterized by a small selection of marketed product options, consisting of chemotherapies, cancer immunotherapies and receptor tyrosine kinase inhibitor products. The pipeline is moderately sized, with 340 products active across all stages of development. First-in-class products only constitute approximately a third of the pipeline, and represent 39% of products with a disclosed target. The most widely studied group of first-in-class targets are cancer immunotherapies. This has been heavily influenced by the success of Opdivo and Keytruda, which are used in the treatment of HNC (after 2016 FDA approvals) and other oncology indications. The first-in-class targets analyzed in this report have shown encouraging efficacy profiles, and some show the ability to chemosensitize cancer cells.
Potential driving factors for the market include a large treatment population, the typically poor outcome, a high chance of recurrence for treated patients, a growing patient pool if disease prognosis can be improved, a lack of targeted therapy options in the market, and the strong understanding of the disease pathophysiology that has developed over the last decade, facilitating the development of novel compounds that may fulfill the unmet needs.
Overall, due to the highly complex and polygenic nature of HNC, which has numerous subtype classifications, it is unlikely that the inhibition of a single target will be sufficient to substantially improve patient prognosis. Instead, it is likely that the concurrent use of multiple targeted therapies alongside other available modes of therapy will improve treatment outcomes.
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