Gutiérrez Calderón Vanesa, Cantero González Alexandra, Gálvez Carvajal Laura, Aguilar Lizarralde Yolanda, Rueda Domínguez Antonio
Unidad de Gestión Clínica Intercentros de Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, IBIMA, Málaga, Spain.
Servicio de Cirugía Maxilofacial, Hospital Regional Universitario, Málaga, Spain.
Ther Adv Med Oncol. 2021 Feb 23;13:1758835920984061. doi: 10.1177/1758835920984061. eCollection 2021.
Squamous cell carcinoma of oral cavity (OCSCC) accounts for approximately 25% of cases of head and neck squamous cell carcinoma (HNSCC). Tobacco and alcohol consumption are the main risk factors for both cancers. Surgical resection, combined with adjuvant radiotherapy or radiochemotherapy in patients with high risk of relapse, is the key element in management in the initial stages. However, despite the availability of aggressive multidisciplinary treatments, advanced resectable OCSCC carries poor prognosis; only half of the patients are disease-free 5 years after the surgery. Immunotherapy based on the use of immune checkpoint inhibitors has been proven to be effective in a wide variety of tumours, including recurrent and metastatic HNSCC. These positive results resulted in investigations into its effectiveness in earlier stages of the disease with OCSCC emerging as an interesting research model because of the accessible location of the tumours. This article reviews the potential advantages of emerging immunotherapeutic agents [mainly monoclonal antibodies against programmed cell death-1 () immune checkpoint inhibitors] as neoadjuvant treatment for OCSCC at locoregional stages as well as the ongoing clinical trials, challenges in evaluating tumour response, and possible predictive biomarkers of response with highlights regarding the role of oral microbiota as modulators of immune response. The efficacy and safety of anti- drugs in these patients have been proven in preliminary trials. If there is a decrease in the relapse rate and an improvement in the overall survival after surgical resection in ongoing trials, preoperative immunotherapy may be established as a treatment option for patients with early stages of the disease.
口腔鳞状细胞癌（OCSCC）约占头颈部鳞状细胞癌（HNSCC）病例的25%。吸烟和饮酒是这两种癌症的主要危险因素。手术切除，联合辅助放疗或放化疗用于复发风险高的患者，是初始阶段治疗的关键要素。然而，尽管有积极的多学科治疗方法，但晚期可切除的OCSCC预后较差；只有一半的患者在手术后5年无疾病。基于免疫检查点抑制剂的免疫疗法已被证明在包括复发和转移性HNSCC在内的多种肿瘤中有效。这些积极结果促使人们研究其在疾病早期阶段的有效性，由于肿瘤位置易于接近，OCSCC成为一个有趣的研究模型。本文综述了新兴免疫治疗药物[主要是抗程序性细胞死亡蛋白1（）免疫检查点抑制剂单克隆抗体]作为OCSCC局部区域阶段新辅助治疗的潜在优势，以及正在进行的临床试验、评估肿瘤反应的挑战和可能的反应预测生物标志物，并重点介绍了口腔微生物群作为免疫反应调节剂的作用。抗药物在这些患者中的疗效和安全性已在初步试验中得到证实。如果在正在进行的试验中手术切除后复发率降低且总生存期改善，术前免疫疗法可能会被确立为疾病早期患者的一种治疗选择。
