Bernier Jacques
Radio-Oncology Division, Genolier Swiss Medical Network, Genolier, Switzerland.
Nat Clin Pract Oncol. 2008 Dec;5(12):705-13. doi: 10.1038/ncponc1228. Epub 2008 Sep 30.
Patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (SCCHN) have a poor prognosis, particularly those whose disease has progressed on previous platinum-containing therapy. The epidermal growth factor receptor (EGFR) is expressed at very high levels in SCCHN and is associated with a poor prognosis. Several phase II-III studies have shown that the EGFR-targeting monoclonal antibody, cetuximab, offers clinical benefit for patients with SCCHN. Cetuximab monotherapy is active in patients whose cancer progresses on platinum-containing therapy. Tumor response and patient survival are in excess of what is achieved with commonly used therapies in this setting. Addition of a platinum regimen to cetuximab in patients with disease that progresses on platinum seems to confer no further benefit over cetuximab alone, either in terms of response rate or survival. In the first-line setting, cetuximab plus platinum and 5-fluorouracil significantly prolongs overall survival compared with platinum and 5-fluorouracil alone. The superior survival observed with cetuximab compared with platinum-based treatment demonstrates that cetuximab is the most active treatment for recurrent and/or metastatic SCCHN, and is of particular clinical significance.
复发性和/或转移性头颈部鳞状细胞癌（SCCHN）患者预后较差，尤其是那些疾病在先前含铂治疗中进展的患者。表皮生长因子受体（EGFR）在SCCHN中高表达，且与预后不良相关。多项II-III期研究表明，靶向EGFR的单克隆抗体西妥昔单抗可为SCCHN患者带来临床益处。西妥昔单抗单药治疗对癌症在含铂治疗中进展的患者有效。肿瘤反应和患者生存率超过了在此情况下常用疗法所达到的水平。对于疾病在铂类治疗中进展的患者，在西妥昔单抗基础上加用铂类方案，无论在缓解率还是生存率方面，似乎都不会比单独使用西妥昔单抗带来更多益处。在一线治疗中，与单独使用铂类和5-氟尿嘧啶相比，西妥昔单抗联合铂类和5-氟尿嘧啶可显著延长总生存期。与基于铂类的治疗相比，西妥昔单抗观察到的更高生存率表明，西妥昔单抗是复发性和/或转移性SCCHN最有效的治疗方法，具有特别的临床意义。
