Combining radiotherapy and immunotherapy in definitive treatment of head and neck squamous cell carcinoma: review of current clinical trials

Plavc, Gaber; Strojan, Primož

doi:10.2478/raon-2020-0060

Cited by 17 publications

(16 citation statements)

References 139 publications

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“…Indeed, immune checkpoint inhibitors have become a standard in the treatment of recurrent or metastatic HNSCC and are now being tested prospectively in the locally-advanced setting. Through immunogenic cancer cell death and effect on the tumour microenvironment and vasculature, RT may enhance the effect of immune checkpoints inhibitors 18 .…”

Section: Discussionmentioning

confidence: 99%

N3 (> 6 cm) squamous cell carcinoma of the head and neck: outcomes and predictive factors in 104 patients

Sellami

Leclere

Lucia

et al. 2021

Acta Otorhinolaryngol Ital

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Objective. To report outcome and predictive factors in patients with N3 (> 6 cm) nonmetastatic locally advanced head and neck squamous cell carcinoma (LAHNSCC) treated with a conservative approach or with initial surgery. Methods. 104 patients were included: 69 treated with radiotherapy (RT) ± chemotherapy (CT) and 35 with nodal surgery with or without primary tumour resection, which was completed in 30 patients by adjuvant RT ± CT. Positron-emission tomography-computed tomography (PET-CT) guided surveillance after RT ± CT was standard. Results. Two-year overall survival (OS) and locoregional control (LRC) were 39.4% and 37.5%, respectively. In univariate analysis, body mass index (BMI), performance status (PS), p16 status and haemoglobin value influenced OS and disease-free survival (DFS). In multivariate analysis, p16 positive status and BMI ≥ 25 remained independent prognostic factors for better OS (p = 0.023) and DFS (p = 0.002). Only under/normal weight remained an independent and adverse significant prognostic factor in multivariate analysis for regional control (RC). Patients treated with primary RT ± CT had slightly better 2-year OS (43.5% versus 33.3%, p = 0.31). Conclusions. Patients with N3 LAHNSCC have poor prognosis, but long term LRC is achievable, especially in overweight patients and those with a good PS. KEY WORDS: N3 (> 6 cm), head and neck cancer, surgery, radiotherapy, prognostic factors RIASSUNTO Obiettivo. Analizzare i risultati e fattori predittivi in pazienti con carcinoma a cellule squamose della testa e del collo localmente avanzato non metastatico con N3 (> 6 cm) (LAHN-SCC N3) trattati con un approccio conservativo o con intervento chirurgicoMetodi. Sono stati inclusi 104 pazienti: 69 trattati con radioterapia (RT) ± chemioterapia (CT) e 35 con chirurgia linfonodale con o senza resezione del tumore primario, di cui 30 pazienti con RT ± CT adiuvante. La sorveglianza dopo RT ± CT è stata eseguita mediante tomografia computerizzata a emissione di positroni (PET-TC) Risultati. La sopravvivenza globale (OS) a 2 anni e il controllo locoregionale (LRC) erano rispettivamente del 39,4% e del 37,5%. Nell'analisi univariata, l'indice di massa corporea (BMI), il performance status (PS), lo stato di p16 e il valore dell'emoglobina hanno influenzato l'OS e la sopravvivenza libera da malattia (DFS). Nell'analisi multivariata, la positività di p16 e il BMI ≥ 25 sono rimasti fattori prognostici indipendenti per una migliore OS (p = 0,023) e DFS (p = 0,002). Lo stato di malnutrizione o normale status nutrizionale sono rimasti fattori prognostici significativi indipendenti e negativi nell'analisi multivariata per il controllo regionale (RC). I pazienti trattati con RT ± CT primaria avevano una OS a 2 anni leggermente migliore (43,5% contro 33,3%, p = 0,31). Conclusioni. I pazienti con LAHNSCC N3 hanno una prognosi sfavorevole, ma è possibile ottenere un LRC a lungo termine, specialmente nei pazienti in sovrappeso e in quelli con un buon PS.

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Section: Discussionmentioning

confidence: 99%

N3 (> 6 cm) squamous cell carcinoma of the head and neck: outcomes and predictive factors in 104 patients

Sellami

Leclere

Lucia

et al. 2021

Acta Otorhinolaryngol Ital

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“…The same can be said about the GORTEC 2015-01 PembroRad trial, which failed to improve locoregional control over SOC using pembrolizumab plus radiation (125). However, these are just two of the many ongoing trials involving LA HNSCC (118)(119)(120)(121)(122)(123). More importantly, some recent trials, albeit fewer in comparison, are now evaluating ICIs combinations specifically in LA, HPV + OPSCC with and without reductions in the dosage of radiation (Table 1).…”

Section: Targeting the Tumor Microenvironment Of Hpv +-Hnsccmentioning

confidence: 98%

“…Harnessing the positive effects of radio-and chemotherapy can therefore increase the proportion of responders and amplitude of response to ICIs and help with de-escalation endeavors. To that end, a number of clinical trials have incorporated ICIs in combination with radiation, chemotherapy or experimental targeted therapies for evaluation in LA HNSCC (118)(119)(120)(121)(122)(123).…”

Section: Targeting the Tumor Microenvironment Of Hpv +-Hnsccmentioning

confidence: 99%

Targeted Therapy as a Potential De-Escalation Strategy in Locally Advanced HPV-Associated Oropharyngeal Cancer: A Literature Review

Chitsike

Duerksen-Hughes

2021

Front. Oncol.

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The treatment landscape of locally advanced HPV-oropharyngeal squamous cell carcinoma (OPSCC) is undergoing transformation. This is because the high cures rates observed in OPSCC are paired with severe treatment-related, long-term toxicities. These significant adverse effects have led some to conclude that the current standard of care is over-treating patients, and that de-intensifying the regimens may achieve comparable survival outcomes with lower toxicities. Consequently, several de-escalation approaches involving locally advanced OPSCC are underway. These include the reduction of dosage and volume of intensive cytotoxic regimens, as well as elimination of invasive surgical procedures. Such de-intensifying treatments have the potential to achieve efficacy and concurrently alleviate morbidity. Targeted therapies, given their overall safer toxicity profiles, also make excellent candidates for de-escalation, either alone or alongside standard treatments. However, their role in these endeavors is currently limited, because few targeted therapies are currently in clinical use for head and neck cancers. Unfortunately, cetuximab, the only FDA-approved targeted therapy, has shown inferior outcomes when paired with radiation as compared to cisplatin, the standard radio-sensitizer, in recent de-escalation trials. These findings indicate the need for a better understanding of OPSCC biology in the design of rational therapeutic strategies and the development of novel, OPSCC-targeted therapies that are safe and can improve the therapeutic index of standard therapies. In this review, we summarize ongoing research on mechanism-based inhibitors in OPSCC, beginning with the salient molecular features that modulate tumorigenic processes and response, then exploring pharmacological inhibition and pre-clinical validation studies of candidate targeted agents, and finally, summarizing the progression of those candidates in the clinic.

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“…Several studies have been performed with different strategies regarding the treatment of head and neck carcinoma. Whether combining drugs with radiation or just using immunotherapy, recent trials indicated positive results regarding not only the regression of the tumors, control of metastatic rates and recurrent behavior, but also severe adverse events (85). The trials looked at the effects of specific drugs such as HF-10, pembrolizumab, Lenvatinimib, cetuximab, vismodegib or survivin-2B peptide alone or in combination with radiotherapy.…”

Section: Downregulation Of Anti-apoptotic Proteinsmentioning

confidence: 99%

Insight on common forms of cutaneous head and neck carcinoma (Review)

Iancu¹,

Fulga²,

Vesa³

et al. 2023

Mol Clin Oncol

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To improve the outcome and quality of life for patients with head and neck carcinoma, an increasing amount of research has been performed on the particularities of this type of cancer and its treatment methods. Starting from clinical aspects, including histology and imaging features, up-to-date studies from different parts of the world have determined new data leading to a better understanding of the mechanisms behind the disease and proposed new treatment protocols. The head and neck areas are predisposed to almost all skin neoplasms, most commonly those related to ultraviolet exposure. Squamous cell carcinoma and basal cell carcinoma account for almost 90% of non-melanoma skin cancers in this region; therefore, reviewing the literature on cutaneous carcinomas of the head and neck area and sharing particular aspects of their physiopathology are beneficial for a great number of patients. Contents 1. Introduction 2. Squamous cell carcinoma 3. Basal cell carcinoma 4. Treatment challenges 5. Conclusions

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Combining radiotherapy and immunotherapy in definitive treatment of head and neck squamous cell carcinoma: review of current clinical trials

Cited by 17 publications

References 139 publications

N3 (> 6 cm) squamous cell carcinoma of the head and neck: outcomes and predictive factors in 104 patients

N3 (> 6 cm) squamous cell carcinoma of the head and neck: outcomes and predictive factors in 104 patients

Targeted Therapy as a Potential De-Escalation Strategy in Locally Advanced HPV-Associated Oropharyngeal Cancer: A Literature Review

Insight on common forms of cutaneous head and neck carcinoma (Review)

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