Campbell Nicholas P, Hensing Thomas A, Bhayani Mihir K, Shaikh Arif Y, Brockstein Bruce E
a Kellogg Cancer Center , NorthShore University HealthSystem , Evanston , IL , USA.
Expert Rev Anticancer Ther. 2016 Aug;16(8):847-58. doi: 10.1080/14737140.2016.1202116. Epub 2016 Jul 11.
As epidermal growth factor receptor (EGFR) is overexpressed in approximately 90% of squamous cell carcinomas of the head and neck (SCCHN), several therapeutic agents that target EGFR have been evaluated for the treatment of SCCHN. Although patients with SCCHN derive clinical benefit from anti-EGFR agents, most notably the EGFR monoclonal antibody cetuximab, these patients eventually become resistant to EGFR-based therapies; preclinical studies have shown activation of secondary signaling pathways that lead to resistance to EGFR inhibition and, as such, serve as potential therapeutic targets to overcome resistance to EGFR inhibitors.
This review summarizes the results of recently completed trials of anti-EGFR agents in SCCHN, highlights the various mechanisms that drive resistance to EGFR inhibitors in SCCHN, and focuses on several novel targeted agents that could potentially help overcome resistance to EGFR-based therapies in SCCHN. Expert commentary: Due to the development of resistance to EGFR-targeted therapies, novel treatment approaches to overcome resistance are a key unmet need for SCCHN.
由于表皮生长因子受体(EGFR)在大约90%的头颈部鳞状细胞癌(SCCHN)中过度表达,几种靶向EGFR的治疗药物已被评估用于SCCHN的治疗。尽管SCCHN患者从抗EGFR药物中获得了临床益处,最显著的是EGFR单克隆抗体西妥昔单抗,但这些患者最终会对基于EGFR的治疗产生耐药性;临床前研究表明,二级信号通路的激活会导致对EGFR抑制的耐药性,因此,这些通路可作为克服对EGFR抑制剂耐药性的潜在治疗靶点。
本综述总结了近期完成的抗EGFR药物治疗SCCHN试验的结果,强调了SCCHN中导致对EGFR抑制剂耐药的各种机制,并重点介绍了几种可能有助于克服SCCHN中基于EGFR治疗耐药性的新型靶向药物。专家评论:由于对EGFR靶向治疗产生了耐药性,开发新的治疗方法来克服耐药性是SCCHN尚未满足的关键需求。