Turning a negative into a positive.

We’re speaking immunohistochemically, of course. We all know HPV positivity makes a huge difference in outcomes for head and neck (H&N) cancers. But if the p16 stains negative, is there anything else we can look for to predict outcomes? Researchers at MD Anderson suggest using a not-so-novel cell marker as a novel predictor of H&N cancer response to conventional therapy. Nope, not EGFR. We’re talking about this year’s Trump of cancer news feeds: PD-L1. Retrospective genomic analyses of HPV(-) H&N cancers showed that PD-L1 expressers consistently suffered almost triple the local recurrence rates following definitive radiation. Ok...but how will this help our patients? Well, it certainly adds to our predictive models. But, more importantly, this could represent the treatment breakthrough we’ve all be waiting for in the treatment of HPV(-) H&N patients. After all, bad biology is only bad until you find a way to target it (ever heard of a little something called Herceptin?)...and PD-L1 inhibition in combo with radiation may just be breaking bad.