Fazer Casey, Price Katharine A
Division of Medical Oncology, Mayo Clinic, Rochester, MN.
JCO Oncol Pract. 2020 Feb;16(2_suppl):20s-24s. doi: 10.1200/JOP.19.00648.
On June 10, 2019, the US Food and Drug Administration approved pembrolizumab for first-line treatment of metastatic or unresectable human papillomavirus (HPV)-positive and HPV-negative recurrent head and neck squamous cell carcinoma (HNSCC) based on the KEYNOTE-048 phase III study. Pembrolizumab is now the first anti-programmed cell death protein 1 (PD-1) therapy approved in the first-line HNSCC setting. Pembrolizumab is approved as first-line monotherapy for tumors that express programmed death-ligand 1 (PD-L1) or in combination with chemotherapy regardless of PD-L1 expression. As the indications for immunotherapy for HNSCC broaden, practitioners will need to know how to recognize and manage more immunotherapy-related toxicities. The following case study provides insight into the assessment and management of the specific immune-related toxicities of dermatitis and mucositis associated with pembrolizumab-chemotherapy combination therapy using Immuno-Oncology Essentials guidance. Assessment and early management of immunotherapy toxicity is critical, as is a multidisciplinary approach.
2019年6月10日，美国食品药品监督管理局基于KEYNOTE-048 III期研究，批准帕博利珠单抗用于转移性或不可切除的人乳头瘤病毒（HPV）阳性和HPV阴性复发性头颈部鳞状细胞癌（HNSCC）的一线治疗。帕博利珠单抗现已成为首个在一线HNSCC治疗中获批的抗程序性细胞死亡蛋白1（PD-1）疗法。帕博利珠单抗被批准作为一线单药疗法用于表达程序性死亡配体1（PD-L1）的肿瘤，或无论PD-L1表达情况如何，均可与化疗联合使用。随着HNSCC免疫治疗适应证的拓宽，临床医生需要了解如何识别和处理更多与免疫治疗相关的毒性反应。以下病例研究利用免疫肿瘤学要点指南，深入探讨了帕博利珠单抗-化疗联合治疗相关的特异性免疫相关毒性（皮炎和粘膜炎）的评估和管理。免疫治疗毒性的评估和早期管理至关重要，多学科方法同样重要。
