Department of Head and Neck Surgery, Greek Anticancer Institute, Saint Savvas Hospital, 171 Alexandras Avenue, 115 22 Athens, Greece.
J Oncol. 2009;2009:346345. doi: 10.1155/2009/346345. Epub 2009 Aug 9.
Patients with head and neck squamous cell carcinoma (HNSCC) are at considerable risk for death, with 5-year relative survival rates of approximately 60%. The profound multifaceted deficiencies in cell-mediated immunity that persist in most patients after treatment may be related to the high rates of treatment failure and second primary malignancies. Radiotherapy and chemoradiotherapy commonly have severe acute and long-term side effects on immune responses. The development of immunotherapies reflects growing awareness that certain immune system deficiencies specific to HNSCC and some other cancers may contribute to the poor long-term outcomes. Systemic cell-mediated immunotherapy is intended to activate the entire immune system and mount a systemic and/or locoregional antitumor response. The delivery of cytokines, either by single cytokines, for example, interleukin-2, interleukin-12, interferon-gamma, interferon-alpha, or by a biologic mix of multiple cytokines, such as IRX-2, may result in tumor rejection and durable immune responses. Targeted immunotherapy makes use of monoclonal antibodies or vaccines. All immunotherapies for HNSCC except cetuximab remain investigational, but a number of agents whose efficacy and tolerability are promising have entered phase 2 or phase 3 development.
头颈部鳞状细胞癌（HNSCC）患者的死亡风险相当高，5 年相对生存率约为 60%。大多数患者在治疗后仍存在细胞介导免疫的严重多方面缺陷，这可能与治疗失败和第二原发恶性肿瘤的高发生率有关。放疗和放化疗通常对免疫反应有严重的急性和长期副作用。免疫疗法的发展反映出人们越来越认识到，HNSCC 和某些其他癌症特有的某些免疫系统缺陷可能导致预后不良。全身细胞介导免疫疗法旨在激活整个免疫系统，引发全身和/或局部抗肿瘤反应。细胞因子的传递，无论是通过单一细胞因子，例如白细胞介素-2、白细胞介素-12、干扰素-γ、干扰素-α，还是通过多种细胞因子的生物混合，例如 IRX-2，都可能导致肿瘤排斥和持久的免疫反应。靶向免疫疗法利用单克隆抗体或疫苗。除西妥昔单抗外，所有用于 HNSCC 的免疫疗法仍处于研究阶段，但许多疗效和耐受性有希望的药物已进入 2 期或 3 期开发。
