Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Sunto-gun, Japan.
Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
Jpn J Clin Oncol. 2020 Sep 28;50(10):1089-1096. doi: 10.1093/jjco/hyaa139.
Squamous cell carcinoma of the head and neck is characterized by an immunosuppressive environment and evades immune responses through multiple resistance mechanisms. A breakthrough in cancer immunotherapy employing immune checkpoint inhibitors has evolved into a number of clinical trials with antibodies against programmed cell death 1 (PD-1), its ligand PD-L1 and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) for patients with squamous cell carcinoma of the head and neck. CheckMate141 and KEYNOTE-048 were practice-changing randomized phase 3 trials for patients with platinum-refractory and platinum-sensitive recurrent or metastatic squamous cell carcinoma of the head and neck, respectively. Furthermore, many combination therapies using anti-CTLA-4 inhibitors, tyrosine kinase inhibitors and immune accelerators are currently under investigation. Thus, the treatment strategy of recurrent or metastatic squamous cell carcinoma of the head and neck is becoming more heterogeneous and complicated in the new era of individualized medicine. Ongoing trials are investigating immunotherapeutic approaches in the curative setting for locoregionally advanced disease. This review article summarizes knowledge of the role of the immune system in the development and progression of squamous cell carcinoma of the head and neck, and provides a comprehensive overview on the development of immunotherapeutic approaches in both recurrent/metastatic and locoregionally advanced diseases.
头颈部鳞状细胞癌的特征是免疫抑制环境,并通过多种耐药机制逃避免疫反应。癌症免疫疗法的突破是使用免疫检查点抑制剂进行了许多临床试验,针对头颈部鳞状细胞癌患者使用了针对程序性细胞死亡 1(PD-1)、其配体 PD-L1 和细胞毒性 T 淋巴细胞相关蛋白 4(CTLA-4)的抗体。CheckMate141 和 KEYNOTE-048 分别是针对铂类难治性和铂类敏感复发性或转移性头颈部鳞状细胞癌患者的具有变革意义的随机 III 期临床试验。此外,目前正在研究许多联合疗法,包括抗 CTLA-4 抑制剂、酪氨酸激酶抑制剂和免疫加速剂。因此,在个体化医学的新时代,复发性或转移性头颈部鳞状细胞癌的治疗策略变得更加多样化和复杂。正在进行的试验正在研究局部晚期疾病的治疗环境中的免疫治疗方法。本文综述了免疫系统在头颈部鳞状细胞癌发生和发展中的作用,并对头颈部复发性/转移性和局部晚期疾病的免疫治疗方法的发展进行了全面概述。