Division of Hematology & Oncology, University of North Carolina Hospitals, Chapel Hill, NC 27599, USA.
Future Oncol. 2018 Jul;14(16):1547-1558. doi: 10.2217/fon-2017-0628. Epub 2018 Feb 21.
Until recently, palliative options for the treatment of platinum-refractory recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) have been cytotoxic chemotherapy and EGFR inhibitors. These agents offer limited efficacy with substantial toxicity. The development of novel immune checkpoint inhibitors has challenged the standard treatment. Pembrolizumab is a potent and highly selective humanized monoclonal antibody that blocks the interaction between PD-1, an immune checkpoint receptor and its ligands PD-L1 and -2. In August 2016, the US FDA approved the use of pembrolizumab in R/M HNSCC following disease progression on or after platinum-containing chemotherapy. This review highlights the pharmacology, therapeutic efficacy and tolerability data relevant to the use of pembrolizumab for the treatment of R/M HNSCC. Readers will gain greater insight into the HNSCC tumor microenvironment, available biomarkers, and learn about important clinical considerations associated with the use of pembrolizumab and similar immune checkpoint inhibitors.
直到最近，针对铂类耐药复发性或转移性头颈部鳞状细胞癌（R/M HNSCC）的姑息治疗选择一直是细胞毒性化疗和 EGFR 抑制剂。这些药物的疗效有限，但毒性较大。新型免疫检查点抑制剂的发展挑战了标准治疗方法。Pembrolizumab 是一种强效且高度选择性的人源化单克隆抗体，可阻断 PD-1（一种免疫检查点受体）与其配体 PD-L1 和 -2 之间的相互作用。2016 年 8 月，美国食品和药物管理局（FDA）批准 pembrolizumab 用于铂类化疗后疾病进展的 R/M HNSCC。这篇综述重点介绍了 pembrolizumab 治疗 R/M HNSCC 的药理学、治疗效果和耐受性数据。读者将更深入地了解 HNSCC 肿瘤微环境、可用的生物标志物，并了解与 pembrolizumab 和类似免疫检查点抑制剂使用相关的重要临床注意事项。
