Drug Development Program, Princess Margaret Hospital, Toronto, Ontario, Canada.
Curr Opin Oncol. 2010 May;22(3):212-20. doi: 10.1097/CCO.0b013e328338001f.
This article reviewed the recent developments in molecular targeted therapy in head and neck cancers. A brief summary of other pathways of interest is also enclosed.
The use of cetuximab in squamous cell head and neck cancer is associated with clinical benefit and, in some cases, survival. However, the use of targeted agents beyond cetuximab in this disease remains investigational. Combination therapy of molecular targeted agents with chemoradiation in the locally advanced setting of head and neck squamous cell carcinomas and nasopharyngeal cancer shows early promising results, but at the expense of increased toxicity. In malignant salivary gland tumors, the evaluation of targeted therapy has been disappointing. New therapeutic targets warrant further evaluation in these cancers.
Despite the encouraging results achieved with antiepidermal growth factor receptor therapy, particularly with cetuximab, targeted therapy trials conducted in head and neck cancers to date have largely lacked efficacy or are associated with significant toxicity. Further research into modulation of other aberrant pathways is needed. The recent identification of improved prognosis among head and neck squamous cell carcinoma patients whose tumors harbor the human papilloma virus may allow better treatment selection for these patients, while the identification of a hallmark gene fusion transcript in adenocystic carcinoma may herald new treatment promise.
本文回顾了头颈部癌症分子靶向治疗的最新进展。同时也简要总结了其他相关通路。
西妥昔单抗在头颈部鳞状细胞癌中的应用与临床获益相关，在某些情况下与生存相关。然而，在这种疾病中，除了西妥昔单抗以外的靶向药物的应用仍在研究中。在头颈部鳞状细胞癌和鼻咽癌的局部晚期，分子靶向药物联合放化疗显示出早期有希望的结果，但代价是增加了毒性。在恶性唾液腺肿瘤中，靶向治疗的评估结果令人失望。需要进一步评估这些癌症中的新治疗靶点。
尽管抗表皮生长因子受体治疗取得了令人鼓舞的结果，特别是西妥昔单抗，但迄今为止，头颈部癌症的靶向治疗试验在疗效方面大多乏善可陈，或者与显著的毒性相关。需要进一步研究其他异常通路的调节。最近发现，人乳头瘤病毒阳性的头颈部鳞状细胞癌患者预后较好，这可能使这些患者的治疗选择更加合理，而腺泡状软组织肉瘤中标志性基因融合转录本的发现可能预示着新的治疗前景。
