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Expert Opin Emerg Drugs. 2013 Dec;18(4):445-59. doi: 10.1517/14728214.2013.842976. Epub 2013 Oct 5.
Conventional treatments for head and neck squamous cell cancer (HNSCC) are not completely effective and present several issues in terms of toxicity. Treatments available consist of surgery, chemoradiotherapy and biological agents.
Tyrosine-kinase inhibitors (TKIs) alone or in combination, already tested or currently under investigation, will be evaluated together with their time placement along the treatment as well as the disease setting where they were used.
From the results of the main trials on TKIs, it emerges that these agents added to chemotherapy in recurrent/metastatic setting do not represent the best approach because of the major side effects, worsened by the complex characteristics of treated patients, and the lack of gain in terms of efficacy. Targeted agents could better exploit their activity in other settings, such as either before local regional treatment or immediately after to modulate biological effects induced by the treatment itself (surgery and/or radiation) and/or concurrently with radiation. Future research should also focus on irreversible pan-HER inhibitors, or combination agents able to overcome primary and acquired resistance, and on relevant biomarkers that would allow for a better therapeutic index of these molecules.
传统的头颈部鳞状细胞癌（HNSCC）治疗方法并不完全有效，而且在毒性方面存在一些问题。现有的治疗方法包括手术、放化疗和生物制剂。
单独或联合使用的酪氨酸激酶抑制剂（TKIs），已经经过测试或正在研究中，将与它们在治疗过程中的时间安排以及使用它们的疾病环境一起进行评估。
从主要的 TKI 试验结果来看，这些药物在复发/转移环境中与化疗联合使用并不能代表最佳方法，因为它们会产生严重的副作用，而且由于治疗患者的复杂特征，副作用会加重，同时在疗效方面也没有获益。靶向药物可以在其他环境中更好地利用其活性，例如在局部区域治疗之前或之后立即使用，以调节治疗本身（手术和/或放疗）引起的生物学效应，或者与放疗同时使用。未来的研究还应集中在不可逆的泛 HER 抑制剂或能够克服原发性和获得性耐药的联合药物上，并研究相关的生物标志物，以提高这些分子的治疗指数。
