Kordbacheh Farzaneh, Farah Camile S
Broad Institute of MIT and Harvard, Boston, MA 02142, USA.
Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA.
Cancers (Basel). 2021 Oct 30;13(21):5471. doi: 10.3390/cancers13215471.
Head and neck cancer affects nearly 750,000 patients, with more than 300,000 deaths annually. Advances in first line surgical treatment have improved survival rates marginally particularly in developed countries, however survival rates for aggressive locally advanced head and neck cancer are still poor. Recurrent and metastatic disease remains a significant problem for patients and the health system. As our knowledge of the genomic landscape of the head and neck cancers continues to expand, there are promising developments occurring in molecular therapies available for advanced or recalcitrant disease. The concept of precision medicine is underpinned by our ability to accurately sequence tumour samples to best understand individual patient genomic variations and to tailor targeted therapy for them based on such molecular profiling. Not only is their purported response to therapy a factor of their genomic variation, but so is their inclusion in biomarker-driven personalised medicine therapeutic trials. With the ever-expanding number of molecular druggable targets explored through advances in next generation sequencing, the number of clinical trials assessing these targets has significantly increased over recent years. Although some trials are focussed on first-line therapeutic approaches, a greater majority are focussed on locally advanced, recurrent or metastatic disease. Similarly, although single agent monotherapy has been found effective in some cases, it is the combination of drugs targeting different signalling pathways that seem to be more beneficial to patients. This paper outlines current and emerging molecular therapies for head and neck cancer, and updates readers on outcomes of the most pertinent clinical trials in this area while also summarising ongoing efforts to bring more molecular therapies into clinical practice.
头颈癌影响着近75万名患者，每年有超过30万人死亡。一线手术治疗的进展仅略微提高了生存率，尤其是在发达国家，然而侵袭性局部晚期头颈癌的生存率仍然很低。复发和转移性疾病对患者和卫生系统来说仍然是一个重大问题。随着我们对头颈癌基因组格局的认识不断扩大，针对晚期或难治性疾病的分子疗法有了令人鼓舞的进展。精准医学的概念基于我们准确对肿瘤样本进行测序的能力，以便最好地了解个体患者的基因组变异，并根据这种分子谱为他们量身定制靶向治疗。他们对治疗的所谓反应不仅是其基因组变异的一个因素，而且他们被纳入生物标志物驱动的个性化医学治疗试验也是如此。随着通过下一代测序技术探索的可成药分子靶点数量不断增加，近年来评估这些靶点的临床试验数量显著增加。虽然一些试验侧重于一线治疗方法，但绝大多数试验侧重于局部晚期、复发或转移性疾病。同样，虽然在某些情况下单药单一疗法已被证明有效，但针对不同信号通路的药物联合使用似乎对患者更有益。本文概述了头颈癌目前和新兴的分子疗法，向读者介绍了该领域最相关临床试验的结果，同时总结了为将更多分子疗法引入临床实践所做的持续努力。
