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将免疫疗法整合到头颈部癌的多模式治疗中。

Integrating Immunotherapy into Multimodal Treatment of Head and Neck Cancer.

作者信息

Rao Yuan James, Goodman Joseph F, Haroun Faysal, Bauman Julie E

机构信息

Division of Radiation Oncology, The George Washington University School of Medicine, Washington, DC 20037, USA.

Division of Head and Neck Surgery, The George Washington University School of Medicine, Washington, DC 20037, USA.

出版信息

Cancers (Basel). 2023 Jan 21;15(3):672. doi: 10.3390/cancers15030672.

Abstract

Patients with locally advanced head and neck squamous cell carcinoma (HNSCC) have a poor prognosis, with a significant risk of progression or death despite multimodal treatment with surgery, chemotherapy, and radiotherapy. Immune checkpoint inhibitors targeting the programmed death receptor-1 (PD1) have dramatically changed the treatment landscape for recurrent/metastatic disease, improving overall survival in both the first- and second-line palliative settings. This success has driven the investigation of treatment strategies incorporating immunotherapy earlier into the multimodal curative-intent or salvage treatment of both locally advanced and recurrent/metastatic HNSCC. This review encompassed the following three subjects, with a focus on recently reported and ongoing clinical trials: (1) the use of neoadjuvant immunotherapy prior to surgery for locally advanced HNSCC, (2) the use of immunochemoradiotherapy for locally advanced head and neck cancers, and (3) novel uses of immunotherapy in the salvage of recurrent/metastatic HNSCC via a combined modality, including reirradiation paradigms. The results of these studies are eagerly awaited to improve patient outcomes in this challenging disease.

摘要

局部晚期头颈部鳞状细胞癌(HNSCC)患者预后较差,尽管接受了手术、化疗和放疗的多模式治疗,仍有显著的进展或死亡风险。靶向程序性死亡受体1(PD1)的免疫检查点抑制剂极大地改变了复发/转移性疾病的治疗格局,提高了一线和二线姑息治疗环境中的总生存率。这一成功推动了将免疫疗法更早纳入局部晚期和复发/转移性HNSCC的多模式根治性或挽救性治疗策略的研究。本综述涵盖以下三个主题,重点关注最近报道的和正在进行的临床试验:(1)局部晚期HNSCC术前新辅助免疫疗法的应用,(2)局部晚期头颈癌的免疫放化疗应用,(3)通过联合模式,包括再照射方案,在复发/转移性HNSCC挽救治疗中免疫疗法的新应用。热切期待这些研究结果能改善这种具有挑战性疾病的患者预后。

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