Management and palliative chemotherapy for metastatic or recurrent squamous cell carcinoma of the head and neck

Machiels, Jean‐Pascal; Schmitz, Sandra

doi:10.1586/era.10.178

Cited by 8 publications

(6 citation statements)

References 116 publications

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“…In the metastatic and recurrent setting, certain chemotherapeutic agents in combination regimens have been shown to be effective in the management of HNC, such as cisplatin/fluorouracil (5-FU), carboplatin/5-FU, cisplatin/paclitaxel, paclitaxel/ ifosfamide/carboplatin and cisplatin/cetuximab (10). Thus, the understanding of the disease and the molecular mechanisms underlying OSCC have become an important focus of HNC treatment research.…”

Section: Discussionmentioning

confidence: 99%

Retinoblastoma and p53 protein expression in pre-malignant oral lesions and oral squamous cell carcinoma

et al. 2012

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Abstract. The retinoblastoma (Rb) and p53 genes play a fundamental role in cell cycle mechanisms, and their deregulation is related to many steps of oral cancer carcinogenesis. This study was conducted to evaluate the expression of the p53 and Rb proteins in malignant and pre-malignant oral cavity lesions. This retrospective study was conducted at the Federal University of Bahia, Salvador, Brazil, and the Molecular Biology Laboratory of the Otorhinolaryngology Department at the University of Heidelberg, Heidelberg, Germany. Excisional biopsy samples of oral cavities were collected from patients with suspected oral lesions. The samples were processed by immunohistochemistry to be classified by a semi-quantitative score: samples with a ≤10% positivity were considered to have weak/negative expression (-); those with 11-50% positivity, moderate expression (+); and those with >50% positivity, high expression (++). Seventy-one patients were studied (75% male; median age, 52 years; range, 24-84). Of the samples studied, 59.4% were oral squamous cell carcinoma (OSCC) and 40.6% were pre-neoplastic lesions (leukoplakia and actinic cheilitis). OSCC presented higher expression of Rb protein compared to pre-malignant lesions: 75 vs. 25% (p<0.001). Pre-neoplastic lesions presented higher expression of p53 protein compared to OSCC lesions: 55.2 vs. 44.8% (p= 0.030). Despite the small number of samples, the expression of these cell cycle biomarkers (p53 and Rb protein) in excisional biopsies suggests that molecular lesion assessment can determine pre-malignant lesions, and that its use may improve the clinical and surgical treatment of early lesions. Thus, p53 protein expression may be related to the early steps of carcinogenesis in OSCC. Finally, a higher Rb expression was also observed in malignant lesions.

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Section: Discussionmentioning

confidence: 99%

Retinoblastoma and p53 protein expression in pre-malignant oral lesions and oral squamous cell carcinoma

et al. 2012

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“…In the past few years several reviews and overviews have been published concerning systemic treatments for patients with recurrent or metastatic SCCHN. [9][10][11][12][13][14][15] The most robustly studied agents are cisplatin, carboplatin, methotrexate, 5-fluorouracil (5-FU), ifosfamide, paclitaxel, and docetaxel (Table 1). Response rates typically range from 10% to 30%, with some outlier reports of higher response rates, typically in older, smaller studies in which patients had received no prior treatment.…”

Section: Single-agent Uncontrolled Studiesmentioning

confidence: 99%

Systemic Therapy for Metastatic or Recurrent Squamous Cell Carcinoma of the Head and Neck

Colevas

2015

J Natl Compr Canc Netw

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This article summarizes the systemic treatment options for patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck, with an emphasis on recommendations based on phase II and III comparison trials of commercially available agents. Many single-agent and combination regimens have activity against these cancers, but improvement in overall survival remains a challenge, and median survivals in this population with best available therapy remain less than 1 year. The major recent advancement has been the introduction of epidermal growth factor receptor inhibitors, with mixed success. Although single-agent treatment with methotrexate, paclitaxel, docetaxel, or 5-fluorouracil remains one standard for many patients, the use of cisplatin- or carboplatin-based multidrug regimens that include cetuximab has become more popular, primarily based on one randomized study demonstrating a modest survival improvement of approximately 3 months associated with the addition of cetuximab. The burdensome adverse event profile of multidrug regimens makes appropriate patient selection for such aggressive treatment challenging, and consideration should include factors such as need for palliation, performance status of the patients, history of prior treatment, convenience, and cost. Genetically targeted and immunologically mediated treatments are promising but remain experimental. Given the worrisome prognosis for these patients, innovative clinical trials are a good option for many patients and deserve support.

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“…Ponovitev je večinoma lokalno in/ali regionalno, pri 20-30% pa pride do oddaljenih zasevkov. Možnosti zdravljenja lokoregionalnega recidiva so ponavadi zelo omejene: kirurško zdravljenje, če je možna radikalna operacija (s pooperativno (kemo)radioterapijo) , obsevanje, v kolikor prej ni bilo obsevanja ali le dodatno paliativno obsevanje ter kemoterapija ali le podporno zdravljenje [6][7][8][9] . Pri ponovljeni bolezni ali pojavu oddaljenih zasevkov je srednje preživetje bolnikov z PCRGV 6-8 mesecev.…”

Section: Uvodunclassified

“…Pri ponovljeni bolezni ali pojavu oddaljenih zasevkov je srednje preživetje bolnikov z PCRGV 6-8 mesecev. Cilj zdravljenja s kemoterapijo v tej fazi bolezni je zmanjšanje tumorja in/ali zasevkov in s tem zmanjšanje simptomov bolezni, preprečevanje pojava novih simptomov in izboljšanje kvalitete življenja [6][7][8][9] . Kombinacija dveh citostatikov (cisplatina in 5-fluorouracila) je postala standardno zdravljenje pri mlajših bolnikih v dobrem splošnem stanju zaradi večjega deleža odgovorov na zdravljenje vendar brez bistvenega podaljšanja preživetja v primerjavi z zdravljenjem samo z metotreksatom 11 .…”

Section: Uvodunclassified

“…Cilj zdravljenja ponovitve bolezni pri bolnikih z PCRGV je kontrola bolezni, morda tudi podaljšanje preživetja. Kemoterapija v primerjavi z najboljšim podpornim zdravljenjem podaljša preživetje za približno 2 meseca, vendar je bila takšna primerjava narejena le v eni raziskavi z majhnim številom bolnikov (cisplatin proti najboljšemu podpornemu zdravljenju) [6][7][8]21 . Ozdravitve so izjemno redke, prav tako preživetja preko 2 let.…”

Section: Razpravaunclassified

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Zdravljenje ponovljene ali metastatske bolezni s tedensko kemoterapijo docetaxel/cisplatin/5-fluorouracil (TCF) pri bolnikih s ploščatoceličnim rakom glave in vratu

2022

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Bolnike z rakom glave in vratu v zelo dobrem splošnem stanju ob lokalni in/ali regionalni ali oddaljeni ponovitvi lahko zdravimo s kombinacijo citostatikov in tarčnega zdravila (cisplatin, 5-fluorouracil in cetuksimab) v tritenskih ciklusih. Bolnike v slabšem splošnem stanju zdravimo z monoterapijo, ponavadi z metotreksatom, s katerim dosežemo manj odgovorov na zdravljenje in krajše preživetje. Na Onkološkem inštitutu v Ljubljani smo pri bolnikih v slabšem splošnem stanju preizkusili zdravljenje s kombinacijo treh citostatikov (docetaksel 20 mg/m2, cisplatin 20 mg/m2 in 5-fluorouracil 350 mg/m2 intravensko) kot tedensko kemoterapijo. Rezultate smo analizirali retrospektivno. Zdravili smo 15 bolnikov, v starosti 45-78 let (srednja starost 60 let), srednje trajanje spremljanja je bilo 9,5 mesecev. Bolniki so prejeli povprečno 9 (4-15) tedenskih aplikacij kemoterapije. Sedeminosemdeset odstotkov bolnikov je imelo klinično korist zdravljenja (popolni odgovor - 2 bolnika, delni odgovor - 6 bolnikov, stagnacija bolezni - 5 bolnikov).

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Management and palliative chemotherapy for metastatic or recurrent squamous cell carcinoma of the head and neck

Cited by 8 publications

References 116 publications

Retinoblastoma and p53 protein expression in pre-malignant oral lesions and oral squamous cell carcinoma

Retinoblastoma and p53 protein expression in pre-malignant oral lesions and oral squamous cell carcinoma

Systemic Therapy for Metastatic or Recurrent Squamous Cell Carcinoma of the Head and Neck

Zdravljenje ponovljene ali metastatske bolezni s tedensko kemoterapijo docetaxel/cisplatin/5-fluorouracil (TCF) pri bolnikih s ploščatoceličnim rakom glave in vratu

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