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Farlow et al. J Cancer Metastasis Treat 2019;5:18 Journal of Cancer
DOI: 10.20517/2394-4722.2018.100 Metastasis and Treatment

Review Open Access

Window of opportunity trials in head and neck
cancer

Janice L. Farlow , Andrew C. Birkeland , Paul L. Swiecicki , J. Chad Brenner , Matthew E. Spector 1
2
1
3,4
1
1 Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
2 Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, CA 94303, USA.
3 Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI 48109, USA.
4 Department of Internal Medicine, Division of Hematology and Oncology, Ann Arbor Veterans Medical Center, Ann Arbor, MI
48105, USA.

Correspondence to: Dr. Matthew Spector, Department of Otolaryngology - Head and Neck Surgery, University of Michigan,
1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA. E-mail: mspector@med.umich.edu

How to cite this article: Farlow JL, Birkeland AC, Swiecicki PL, Brenner JC, Spector ME. Window of opportunity trials in head and
neck cancer. J Cancer Metastasis Treat 2019;5:18. http://dx.doi.org/10.20517/2394-4722.2018.100

Received: 14 Dec 2018 First Decision: 7 Jan 2019 Revised: 14 Jan 2019 Accepted: 22 Jan 2019 Published: 18 Mar 2019

Science Editor: Bingliang Fang Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Abstract
Head and neck squamous cell carcinoma (HNSCC) has a large global burden of disease and poor survival
outcomes. Recent targeted therapies and immunotherapies have been explored in HNSCC, but there has been
limited translation to clinical practice outside of recurrent or metastatic cases. Window of opportunity settings,
where novel agents are administered between cancer diagnosis and planned definitive therapy, have begun to be
employed in HNSCC. Tumor tissue biopsies are obtained at diagnosis and after the investigation treatment, along
with other biospecimens and radiographic exams. Thus, this study design can characterize the safety profiles,
pharmacodynamics, and initial tumor responses to novel therapies in a treatment-naïve subject. Early window
studies have also identified potential biomarkers to predict sensitivity or resistance to treatments. However,
these early investigations have revealed multiple challenges associated with this trial design. In this review, we
discuss recent window of opportunity trials in HNSCC and how they inform design considerations for future
studies.

Keywords: Window of opportunity trial, head and neck cancer, biomarker, translational research, preoperative,
oncology, trials

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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