Licitra Lisa, Bergamini Cristiana, Mirabile Aurora, Granata Roberta
Head and Neck Cancer Medical Oncology Unit, Fondazione IRCCS 'Istituto Nazionale dei Tumori' in Milan, Italy.
Curr Opin Otolaryngol Head Neck Surg. 2011 Apr;19(2):132-7. doi: 10.1097/MOO.0b013e328344b668.
Results of clinical studies on targeted cancer therapies are rapidly accumulating. This is also true in the field of head and neck cancer (HNC). Due to the unique multidisciplinary needs of the disease, it is of paramount importance that physicians who treat HNC are aware of the evolving changes that research is offering.
Many targeted agents directed at inhibiting epithelial growth factor receptors (EGFRs) are under investigation in both curable loco-regional advanced disease in combination with standard treatments and in the recurrent metastatic setting. Human papilloma virus (HPV)-positive tumors present a distinct biological profile. Consequently, the role of targeted agents in this specific setting still needs to be refined. Herein we will briefly review the results of the most recent studies on targeted agents. Cetuximab and other monoclonal antibodies (panitumumab, zalotumumab and nimotumumab) have been already investigated in phase III studies; and some results are now available. Small molecules inhibiting EGFR have still to prove their efficacy. Other agents such as vascular endothelial cell growth factor receptor, vascular endoinsulin-like growth factor 1 receptor, MET, PI3KA and mammalian target of rapamycin inhibitor are in development.
At present treatment options in HNC are changing and include targeted agents with demonstrated efficacy. A better selection based on biological factors of patients who are potentially responsive to such targeted agents is being actively pursued.
关于靶向癌症治疗的临床研究结果正在迅速积累。头颈部癌(HNC)领域也是如此。由于该疾病独特的多学科需求,治疗HNC的医生了解研究中不断变化的进展至关重要。
许多旨在抑制上皮生长因子受体(EGFR)的靶向药物正在可治愈的局部晚期疾病联合标准治疗以及复发转移情况下进行研究。人乳头瘤病毒(HPV)阳性肿瘤具有独特的生物学特征。因此,靶向药物在这种特定情况下的作用仍需进一步明确。在此,我们将简要回顾关于靶向药物的最新研究结果。西妥昔单抗和其他单克隆抗体(帕尼单抗、扎洛妥单抗和尼莫妥单抗)已在III期研究中进行了调查;现在已有一些结果。抑制EGFR的小分子仍需证明其疗效。其他药物如血管内皮细胞生长因子受体、血管内皮胰岛素样生长因子1受体、MET、PI3KA和雷帕霉素抑制剂的哺乳动物靶点正在研发中。
目前HNC的治疗选择正在改变,包括已证明有效的靶向药物。正在积极寻求基于生物学因素对这类靶向药物可能有反应的患者进行更好的选择。