Wiegand Susanne, Wichmann Gunnar, Dietz Andreas
Department of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany.
Front Oncol. 2019 Mar 26;9:191. doi: 10.3389/fonc.2019.00191. eCollection 2019.
Induction chemotherapy (ICT) is an attractive option for advanced head and neck squamous cell carcinoma (HNSCC) patients which has been prospectively evaluated in the context of a multimodality treatment approach. The theoretical benefit is the ability to suppress distant metastases and shrink the tumor while chemotherapy is better tolerated when given sequentially than concurrently. However, clinical trials have failed to show consistent benefit of ICT over concurrent radio-chemotherapy and due to so far lacking level 1 evidence ICT outside larynx organ preservation remains rather investigational. Immune modulation by inhibition of immune checkpoints is an exciting recent development in HNSCC which has mainly been investigated as second line treatment after progression on platinum-based chemotherapy in patients with recurrent/metastatic HNSCC. Due to the promising results in these trials and even more in the first-line trial KEYNOTE-048 and encouraging first preliminary results of preoperative Anti-PD1-application, the role of neoadjuvant immunotherapy is currently under investigation in HNSCC.
诱导化疗（ICT）是晚期头颈部鳞状细胞癌（HNSCC）患者的一种有吸引力的选择，已在多模式治疗方法的背景下进行了前瞻性评估。理论上的益处是能够抑制远处转移并缩小肿瘤，同时序贯给予化疗比同步给予时耐受性更好。然而，临床试验未能显示ICT相对于同步放化疗有一致的益处，并且由于迄今为止缺乏一级证据，喉器官保留以外的ICT仍主要处于研究阶段。通过抑制免疫检查点进行免疫调节是HNSCC领域最近一项令人兴奋的进展，主要作为复发/转移性HNSCC患者铂类化疗进展后的二线治疗进行了研究。由于这些试验取得了有前景的结果，尤其是一线试验KEYNOTE-048取得了更令人鼓舞的结果，以及术前应用抗PD1的初步结果令人振奋，新辅助免疫疗法在HNSCC中的作用目前正在研究中。
