Head and neck squamous cell carcinoma (HNSCC), or head and neck cancer, is a disease area characterised by high levels of unmet need where there is ample opportunity for research and development (R&D) to improve the current treatment algorithm. At present, chemotherapy remains the most preferred treatment across all lines of therapy, followed by the use of Eli Lilly ’s Erbitux (cetuximab) and immunotherapies such as Merck ’s Keytruda (pembrolizumab) and Bristol Myers Squibb’s Opdivo (nivolumab) in later line settings.

Key opinion leaders (KOLs) from across the eight major markets (8MM, namely the US, France, Germany, Italy, Spain, the UK, Japan and urban China) who were interviewed for GlobalData’s upcoming report, ‘Head and Neck Squamous Cell Carcinoma – Global Drug Forecast and Market Analysis to 2030’, shared their expert insights on the HNSCC market. These experts were, overall, moderately satisfied with the currently available medications and relevant clinical data, as well as the pipeline agents in development, particularly new entrants in HNSCC such as Genentech’s Tecentriq (atezolizumab), Kura Oncology ’s tipifarnib, Merck/Debiopharm’s xevinapant and Nektar Therapeutics ’ bempegaldesleukin. These new entrants are poised to be the future clinical and market leaders behind the current market leader, Keytruda, in HNSCC.

The most promising drugs coming through the pipeline modulate the tumour microenvironment and/or the immune system to try to improve the activity of immune checkpoint inhibitors. Experts interviewed by GlobalData expect the most exciting data to emerge from trials studying novel combinations. The recent surge of investment in HNSCC has resulted in a diverse pipeline across multiple lines of therapy, primarily in the locally advanced (LA-HNSCC) and recurrent/metastatic (R/M HNSCC) settings. Because HNSCC is an indication with a high unmet need and little competition exists between currently branded agents, biopharmaceutical companies of varying sizes are attempting to capture their own share of this potentially lucrative market. Based on clinical insights, the key unmet needs in HNSCC have been identified as superior efficacy, overall survival and personalised therapy in LA-HNSCC.

For novel immune checkpoint inhibitors (ICIS ) entering the market, such as Chinese ICIs domestically developed in China, there will be substantial competition from the currently approved therapies, specifically in the US market. With anticipated low pricing, however, these new drugs are expected to provide a commercial advantage to Chinese ICIs. Immunomodulators and other antineoplastic agents entering the market will need to demonstrate substantial clinical benefits, from efficacy and safety perspectives, against established chemotherapies or in combination with these therapies in order to gain traction. If successful, GlobalData expects considerable substitution of toxic chemotherapies with these novel agents.

Keytruda and Erbitux remain the leading brands across all the 8MM, fulfilling several major unmet needs in HNSCC. Based on KOL insights and commercial inputs, GlobalData forecasts that Keytruda will continue to be the leading brand in HNSCC over the forecast period, with label expansions in the induction and adjuvant settings, as well as launches in combination with other pipeline agents. ICIs will remain the leading drug class due to the introduction of leading pipeline agent Tecentriq, as well as several Chinese ICIs in the US and urban China markets.