De Keukeleire Stijn J, Vermassen Tijl, Hilgert Elien, Creytens David, Ferdinande Liesbeth, Rottey Sylvie
Department of Medical Oncology, University Hospital Ghent, 9000 Ghent, Belgium.
Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium.
Cancers (Basel). 2021 Apr 4;13(7):1714. doi: 10.3390/cancers13071714.
The era of immune checkpoint inhibitors has altered the therapeutic landscape in squamous cell cancer of the head and neck (SCCHN). Our knowledge about the tumor microenvironment has fueled the research in SCCHN, leading to several well-known and less-known prognostic and predictive biomarkers. The clinical staging, p16/HPV status, and PD-L1 expression are currently the main tools for assessing the patients' diagnosis and prognosis. However, several novel biomarkers have been thoroughly investigated, some reaching actual significant clinical contributions. The untangling of the immune infiltrate with the subtyping of tissue-associated tumor infiltrating lymphocytes, tumor-associated macrophages, and circulating blood-based biomarkers are an interesting avenue to be further explored and prospectively assessed. Although PD-L1 expression remains the most important response predictor for immune checkpoint inhibitors, several flaws impede proper assessment such as technical issues, different scoring protocol, and intra-, inter-, and temporal heterogeneity. In addition, the construction of an immune-related gene panel has been proposed as a prognostic and predictive stratification but lacks consensus. Recently, the role of microbioma have also been explored regarding its systemic and antitumor immunity. This review gives a comprehensive overview of the aforementioned topics in SCCHN. To this end, the integration of these clinically advantageous biomarkers via construction of an immunogram or nomogram could be an invaluable tool for SCCHN in future prospects.
免疫检查点抑制剂时代改变了头颈部鳞状细胞癌（SCCHN）的治疗格局。我们对肿瘤微环境的了解推动了SCCHN的研究，催生了一些知名和不太知名的预后及预测生物标志物。临床分期、p16/HPV状态和PD-L1表达目前是评估患者诊断和预后的主要工具。然而，一些新型生物标志物已得到深入研究，其中一些已在临床上做出了实际的重大贡献。通过对组织相关肿瘤浸润淋巴细胞、肿瘤相关巨噬细胞进行亚型分类以及基于循环血液的生物标志物来解析免疫浸润，是一个有待进一步探索和前瞻性评估的有趣途径。尽管PD-L1表达仍然是免疫检查点抑制剂最重要的反应预测指标，但存在一些缺陷阻碍了其准确评估，如技术问题、不同的评分方案以及内部、外部和时间上的异质性。此外，构建免疫相关基因panel已被提议用于预后和预测分层，但尚未达成共识。最近，微生物群在全身和抗肿瘤免疫方面的作用也得到了探索。本综述全面概述了SCCHN中的上述主题。为此，通过构建免疫图或列线图整合这些具有临床优势的生物标志物，可能会成为SCCHN未来发展中一项极具价值的工具。
