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转移性和复发性头颈癌靶向治疗建议的结果

Outcome of Targeted Therapy Recommendations for Metastatic and Recurrent Head and Neck Cancers.

作者信息

Taghizadeh Hossein, Mader Robert M, Müllauer Leonhard, Fuereder Thorsten, Kautzky-Willer Alexandra, Prager Gerald W

机构信息

Department of Medicine I, Clinical Division of Oncology, Medical University of Vienna, 1090 Vienna, Austria.

Comprehensive Cancer Center Vienna, 1090 Vienna, Austria.

出版信息

Cancers (Basel). 2020 Nov 15;12(11):3381. doi: 10.3390/cancers12113381.

Abstract

Recurrent/metastatic (R/M) head and neck cancers bear a poor prognosis. In this analysis, we examined the efficacy and the outcome of targeted therapy recommendations based on the patients' molecular tumor portrait after failure of all standard therapy options. In this single-center, real-world retrospective analysis of our platform for precision medicine, we analyzed the molecular profile of 50 patients diagnosed with R/M head and neck cancer. Tumor samples of the patients were examined using next-generation sequencing panels of mutation hotspots, microsatellite instability (MSI) testing, and immunohistochemistry (IHC). In 31 cases (62.0% of all patients), a molecular-driven targeted therapy approach was recommended. Eventually, 14 patients (28%) received the suggested targeted therapy. Six of fourteen patients (43%) achieved stable disease conditions and four patients (29%) experienced a progressive disease. The median time to treatment failure was 2.8 months. Therapy recommendations were significantly more often issued for men ( = 0.037) than for women. This analysis demonstrated that precision medicine provided the basis for molecular-driven therapy recommendations in over half of the patients with advanced therapy refractory head and neck cancers, with significantly more therapy recommendations for men. Our analysis showed that although precision medicine approaches are implementable and feasible for the management of recurrent/metastatic head and neck cancers in daily clinical routine, there are major limitations and challenges that have to be overcome.

摘要

复发性/转移性(R/M)头颈癌预后较差。在本分析中,我们研究了在所有标准治疗方案均失败后,基于患者分子肿瘤特征的靶向治疗建议的疗效和结果。在这项针对我们精准医学平台的单中心、真实世界回顾性分析中,我们分析了50例诊断为R/M头颈癌患者的分子特征。使用突变热点的二代测序面板、微卫星不稳定性(MSI)检测和免疫组织化学(IHC)对患者的肿瘤样本进行检测。在31例病例(占所有患者的62.0%)中,推荐了分子驱动的靶向治疗方法。最终,14例患者(28%)接受了建议的靶向治疗。14例患者中有6例(43%)病情稳定,4例患者(29%)病情进展。治疗失败的中位时间为2.8个月。男性接受治疗建议的频率显著高于女性( = 0.037)。该分析表明,精准医学为超过半数的晚期治疗难治性头颈癌患者提供了分子驱动治疗建议的依据,男性接受治疗建议的比例显著更高。我们的分析表明,尽管精准医学方法在日常临床实践中对于复发性/转移性头颈癌的管理是可实施且可行的,但仍有一些主要的局限性和挑战需要克服。

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