Przybylski Krzysztof, Majchrzak Ewa, Weselik Liucija, Golusiński Wojciech
Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu Wydział Lekarski II Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej.
Otolaryngol Pol. 2018 Sep 6;72(6):10-16. doi: 10.5604/01.3001.0012.4367.
Treating patients with squamous cell carcinoma of the head and neck is a significant problem. There is an increase in the incidence of malignant neoplasms in this region. Surgery, radiotherapy, and chemotherapy are often not sufficient methods of treatment. Thorough analysis of processes occurring in the tumor microenvironment has allowed to distinguish three stages that make up the reaction of the human body to hostile antigens, which are tumor antigens. Understanding these mechanisms has resulted in the introduction of a new term immunooncology. It is an area of cancer treatment that focuses on the use of the patient's immune system to combat the disease. Immunotherapy has had positive effects in cancer patients. The use of immune checkpoint inhibitors, such as anti-CTLA-4 and PD-1 monoclonal antibodies has enabled the modulation of T cell functions, consequently eliminating immunosuppression in the tumor microenvironment. Clinical trials were conducted using nivolumab and ipilimumab, which confirmed their clinical usefulness. The approval by FDA of nivolumab in the treatment of recurrent and metastatic squamous cell carcinoma of the head and neck has increased the overall survival time of patients as well as disease-free survival. Statistical data indicate an advantage of immunotherapy over other treatment methods at an advanced stage of cancer. This work aims to discuss basic issues related to immunotherapy, in particular, immunotherapy in patients with squamous cell carcinoma of the head and neck.
治疗头颈部鳞状细胞癌患者是一个重大问题。该区域恶性肿瘤的发病率在上升。手术、放疗和化疗往往并非充分的治疗方法。对肿瘤微环境中发生的过程进行深入分析后，已能够区分出构成人体对肿瘤抗原（即敌对抗原）反应的三个阶段。对这些机制的理解催生了一个新术语——免疫肿瘤学。它是癌症治疗的一个领域，专注于利用患者的免疫系统来对抗疾病。免疫疗法已在癌症患者中产生了积极效果。使用免疫检查点抑制剂，如抗CTLA - 4和PD - 1单克隆抗体，能够调节T细胞功能，从而消除肿瘤微环境中的免疫抑制。使用纳武单抗和伊匹单抗进行了临床试验，证实了它们的临床效用。美国食品药品监督管理局（FDA）批准纳武单抗用于治疗复发性和转移性头颈部鳞状细胞癌，提高了患者的总生存时间以及无病生存期。统计数据表明，在癌症晚期，免疫疗法相对于其他治疗方法具有优势。本文旨在讨论与免疫疗法相关的基本问题，特别是头颈部鳞状细胞癌患者的免疫疗法。
