Department of Medical Oncology, Tata Memorial Centre, HBNI, Mumbai, India.
Department of Medical Oncology, Tata Memorial Centre, HBNI, Mumbai, India.
Oral Oncol. 2020 Jun;105:104673. doi: 10.1016/j.oraloncology.2020.104673. Epub 2020 Apr 6.
The focus of this review article is to throw light on non-conventional systemic chemotherapy that affects the tumour microenvironment and potentially has a favourable impact on the management of squamous cell cancer of the oral cavity. A metronomic combination of weekly methotrexate and celecoxib seems equally effective to single agent cisplatin in the palliative setting, but needs phase III testing. The same metronomic combination seems inferior to paclitaxel-cetuximab. Triple drug metronomic chemotherapy (methotrexate, celecoxib, and erlotinib) is still under development with promising data from pilot studies. Metronomic chemotherapy also seems beneficial in the curative setting but results of confirmatory studies are eagerly awaited. The low rate of adverse events and low cost make this regimen an attractive alternative. Both in vivo and in-vitro data suggests that numerous drugs like anthelmintics, DMARDs, antimalarials can be repurposed for Head and Neck Cancers. However, there is a dearth of clinical studies reported till date.
本文的重点是探讨非传统的全身化疗，这种化疗会影响肿瘤微环境，并有可能对口腔鳞状细胞癌的治疗产生有利影响。每周使用甲氨蝶呤和塞来昔布的节拍式联合治疗在姑息治疗环境中与单药顺铂同样有效，但需要进行 III 期试验。同样的节拍式联合治疗似乎不如紫杉醇-西妥昔单抗。三药节拍式化疗（甲氨蝶呤、塞来昔布和厄洛替尼）仍在开发中，来自初步研究的结果很有前景。节拍式化疗在根治性治疗中也有获益，但仍迫切需要确认性研究的结果。这种方案的不良反应发生率低，成本低，因此具有吸引力。体内和体外数据均表明，许多药物，如驱虫药、DMARDs、抗疟药，可被重新用于头颈部癌症。然而，迄今为止，报告的临床研究很少。
