Charité Comprehensive Cancer Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Oncol Res Treat. 2016;39(12):780-786. doi: 10.1159/000452432. Epub 2016 Nov 22.
Head and neck squamous cell carcinoma (HNSCC) is one of the most common solid cancers worldwide. It is mainly caused by exposure to tobacco smoke and alcohol as well as infection with the human papilloma virus (HPV). The prognosis is poor, especially once it recurs or metastasizes. Current therapeutic options include surgery, radio- and chemotherapy. Epidermal growth factor receptor (EGFR) inhibitors are so far the only targeted agents that have been approved in head and neck cancer. Primary or secondary resistance is frequent or will eventually develop. Several driver mutations and other genomic aberrations have been described in HNSCC including EGFR overexpression and amplification. Yet, no predictive biomarkers for the application of EGFR inhibitors have been identified. Further targeted agents are in development for HNSCC, of which inhibitors of the PI3K pathway are the closest to clinical application. In recent years, the incidence of HPV-driven HNSCC has risen in Western countries. HPV-positive and -negative HNSCC are distinct molecular tumor entities, and consequences for targeted therapies have been discussed. This review looks at approved and investigational targeted treatment strategies as well as potential predictive biomarkers such as the HPV status to guide treatment.
头颈部鳞状细胞癌（HNSCC）是全球最常见的实体癌症之一。它主要由暴露于烟草烟雾和酒精以及人乳头瘤病毒（HPV）感染引起。预后较差，尤其是复发或转移后。目前的治疗选择包括手术、放化疗。表皮生长因子受体（EGFR）抑制剂是迄今为止唯一在头颈部癌症中获得批准的靶向药物。原发性或继发性耐药性很常见，或者最终会出现耐药性。HNSCC 中已经描述了几种驱动突变和其他基因组异常，包括 EGFR 过表达和扩增。然而，尚未确定 EGFR 抑制剂应用的预测生物标志物。还有其他针对 HNSCC 的靶向药物正在开发中，其中 PI3K 通路抑制剂最接近临床应用。近年来，HPV 驱动的 HNSCC 在西方国家的发病率有所上升。HPV 阳性和阴性的 HNSCC 是不同的分子肿瘤实体，已经讨论了针对这些肿瘤实体的靶向治疗的结果。这篇综述探讨了已批准和正在研究的靶向治疗策略，以及潜在的预测生物标志物，如 HPV 状态，以指导治疗。
