Liu Yan, Zhang Nannan, Wen Yi, Wen Jiaolin
Frontiers Medical Center Tianfu Jincheng Laboratory Chengdu China.
National Facility for Translational Medicine (Sichuan) West China Hospital of Sichuan University Chengdu China.
MedComm (2020). 2024 Aug 21;5(9):e702. doi: 10.1002/mco2.702. eCollection 2024 Sep.
Head and neck cancer (HNC) is a highly aggressive type of tumor characterized by delayed diagnosis, recurrence, metastasis, relapse, and drug resistance. The occurrence of HNC were associated with smoking, alcohol abuse (or both), human papillomavirus infection, and complex genetic and epigenetic predisposition. Currently, surgery and radiotherapy are the standard treatments for most patients with early-stage HNC. For recurrent or metastatic (R/M) HNC, the first-line treatment is platinum-based chemotherapy combined with the antiepidermal growth factor receptor drug cetuximab, when resurgery and radiation therapy are not an option. However, curing HNC remains challenging, especially in cases with metastasis. In this review, we summarize the pathogenesis of HNC, including genetic and epigenetic changes, abnormal signaling pathways, and immune regulation mechanisms, along with all potential therapeutic strategies such as molecular targeted therapy, immunotherapy, gene therapy, epigenetic modifications, and combination therapies. Recent preclinical and clinical studies that may offer therapeutic strategies for future research on HNC are also discussed. Additionally, new targets and treatment methods, including antibody-drug conjugates, photodynamic therapy, radionuclide therapy, and mRNA vaccines, have shown promising results in clinical trials, offering new prospects for the treatment of HNC.
头颈癌(HNC)是一种侵袭性很强的肿瘤类型,其特点是诊断延迟、复发、转移、再发以及耐药。头颈癌的发生与吸烟、酗酒(或两者兼有)、人乳头瘤病毒感染以及复杂的遗传和表观遗传易感性有关。目前,手术和放疗是大多数早期头颈癌患者的标准治疗方法。对于复发或转移性(R/M)头颈癌,当再次手术和放疗不可行时,一线治疗是铂类化疗联合抗表皮生长因子受体药物西妥昔单抗。然而,治愈头颈癌仍然具有挑战性,尤其是在发生转移的情况下。在本综述中,我们总结了头颈癌的发病机制,包括遗传和表观遗传变化、异常信号通路以及免疫调节机制,以及所有潜在的治疗策略,如分子靶向治疗、免疫治疗、基因治疗、表观遗传修饰和联合治疗。还讨论了可能为未来头颈癌研究提供治疗策略的近期临床前和临床研究。此外,新的靶点和治疗方法,包括抗体药物偶联物、光动力疗法、放射性核素疗法和mRNA疫苗,在临床试验中已显示出有前景的结果,为头颈癌的治疗提供了新的前景。