Szturz Petr, Fuereder Thorsten, Guo Ye, Licitra Lisa, Mesia Ricard, Ivanyi Philipp, Falco Agustin, Tahara Makoto, Solbes Marie-Noelle, Venturini Filippo, Bossi Paolo
Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1005 Lausanne, Switzerland.
Department of Medicine I, Division of Oncology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
Cancer Treat Rev. 2025 Apr;135:102910. doi: 10.1016/j.ctrv.2025.102910. Epub 2025 Mar 1.
Treatment options for patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) have evolved over the past decade and have helped improve survival outcomes for patients. Most national and regional guidelines recommend first-line therapy with an immune checkpoint inhibitor (with or without chemotherapy) or a cetuximab-based regimen, by assessment of expression levels of the biomarker programmed cell death-ligand 1 (PD-L1). However, patient- and tumor-specific factors, including the patient's age, comorbidities, performance status, and tumor burden, kinetics and spread also need to be considered to optimize treatment in the first line. Additionally, with increasing availability of newer therapies globally, it is crucial to customize the subsequent second- or later-line therapy based on patient characteristics, including the previous therapy received. This review highlights the factors that should be considered for treatment decision-making in patients with R/M SCCHN. It also summarizes the current evidence for clinical outcomes based on treatment sequencing and provides guidance on choosing an optimal treatment regimen for patients in the first-line treatment setting and beyond.
在过去十年中，复发性和/或转移性头颈部鳞状细胞癌（R/M SCCHN）患者的治疗选择不断发展，并有助于改善患者的生存结果。大多数国家和地区指南建议，通过评估生物标志物程序性死亡配体1（PD-L1）的表达水平，采用免疫检查点抑制剂（联合或不联合化疗）或基于西妥昔单抗的方案进行一线治疗。然而，还需要考虑患者和肿瘤特异性因素，包括患者的年龄、合并症、体能状态、肿瘤负荷、动力学和扩散情况，以优化一线治疗。此外，随着全球新型疗法的可及性不断提高，根据患者特征（包括既往接受的治疗）定制后续二线或更晚期治疗至关重要。本综述强调了R/M SCCHN患者治疗决策应考虑的因素。它还总结了基于治疗顺序的临床结果的现有证据，并为一线及后续治疗中为患者选择最佳治疗方案提供指导。
