Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA.
Division of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA.
Cancer Rep (Hoboken). 2024 Oct;7(10):e70023. doi: 10.1002/cnr2.70023.
Recurrent squamous cell carcinoma (SCC) of the head and neck (SCCHN) remains a formidable clinical challenge despite available treatments. The phosphatidylinositol 3-kinase (PI3K) pathway has been identified as a potential therapeutic target, and alpelisib, a selective PI3Kα inhibitor, has demonstrated efficacy in certain malignancies. Combining this targeted therapy with immunotherapy has been suggested in previous studies as a promising strategy to bolster the immune response against cancer.
A 69-year-old woman with locoregional recurrence of PIK3CA-mutated SCC of the left maxilla and cervical nodal metastases. Several chemotherapeutic regimens, including cisplatin, docetaxel, 5FU, chemoradiotherapy, and mono-immunotherapy, resulted in disease progression. Alpelisib combined with pembrolizumab led to a sustained response for 9 months. A 58-year-old man with recurrent metastatic PIK3CA-mutated SCC of the oropharynx, involving the left lung, hilar, and mediastinal lymph nodes. Despite prior palliative radiation and platinum-based chemotherapy with pembrolizumab and cetuximab, treatment with alpelisib and nivolumab resulted in a partial response. Severe hyperglycemia and rash led to treatment discontinuation.
Our findings highlight the potential of this innovative therapeutic combination, suggesting a need for further investigations in this setting.
尽管已有多种治疗方法，但复发性头颈部鳞状细胞癌（SCCHN）仍然是一个严峻的临床挑战。磷酸肌醇 3-激酶（PI3K）通路已被确定为一种潜在的治疗靶点，而选择性 PI3Kα 抑制剂 alpelisib 在某些恶性肿瘤中已显示出疗效。在之前的研究中，已经提出将这种靶向治疗与免疫疗法相结合，作为增强针对癌症的免疫反应的一种有前途的策略。
一名 69 岁女性，患有左上颌 PIK3CA 突变型 SCC 局部复发和颈部淋巴结转移。几种化疗方案，包括顺铂、多西他赛、5FU、放化疗和单免疫疗法，均导致疾病进展。Alpelisib 联合 pembrolizumab 导致持续 9 个月的缓解。一名 58 岁男性，复发性转移性 PIK3CA 突变型口咽 SCC，累及左肺、肺门和纵隔淋巴结。尽管先前进行了姑息性放疗和含铂化疗联合 pembrolizumab 和 cetuximab，但 alpelisib 和 nivolumab 治疗导致部分缓解。严重的高血糖和皮疹导致治疗中断。
我们的发现强调了这种创新治疗组合的潜力，表明在这种情况下需要进一步研究。
