HNO

, Volume 60, Issue 11, pp 951–956 | Cite as

Neue Aspekte zur aktuellen Therapie von Oropharynxkarzinomen

Highlights vom ASCO-Kongress 2012
  • M. Loewenthal
  • E. Vitez
  • S. Laban
  • A. Münscher
  • B. Güldenzoph
  • R. Knecht
  • C.-J. Busch
Leitthema

Zusammenfassung

Neben der chirurgischen Therapie von Kopf-Hals-Tumoren wird heutzutage vor allem bei lokal fortgeschrittenen Stadien von Oropharynxkarzinomen eine organ- und funktionserhaltende Therapie angestrebt. Gegenstand aktueller prospektiver Studien ist der direkte Vergleich zwischen Induktionschemotherapie plus  Radiochemotherapie (RCT) und einer primär konkomitanten RCT. Neue Ansätze von Kombinationen aus Radio(chemo)therapie und Target-Therapeutika werden ebenfalls in klinischen Studien untersucht. Molekularbiologische Parameter und potenzielle neue therapeutische Targets werden in zahlreichen Studien evaluiert. Die günstige Prognose HPV-positiver Tumoren führt zu dem Wunsch, aktuelle Therapieregime zu deintensivieren, um den Patienten unnötige Toxizitäten zu ersparen. Die Bedeutung spezifischer Therapien nimmt aufgrund der stetig steigenden Inzidenz an HPV-positiven Karzinomen bei jungen Patienten zu.

Schlüsselwörter

Oropharynxtumoren Induktionschemotherapie Radiochemotherapie Biomarker Humanes Papillomavirus 16 

New aspects of current therapeutic strategies in oropharyngeal carcinoma

Highlights of the 2012 ASCO meeting

Abstract

Beside the surgical treatment of head and neck cancer, the concept of organ and function preserving therapy of locally advanced HNSCC (head and neck squamous cell carcinoma) especially of oropharyngeal origin is becoming increasingly important. The comparison of induction chemotherapy plus chemoradiation and primary concomitant chemoradiation has recently been the subject of randomized clinical trials. New combinations of different (chemo)radiation regimens and targeted therapies are also under investigation for HNSCC. Molecular markers predicting treatment efficacy as well as new potential targets are also being evaluated in several clinical trials. The good prognosis of HPV-associated HNSCC has sparked efforts to deintensify treatment to minimize therapy-related toxicities. The impact of specific therapies is growing due to the increasing incidence of young patients with HPV-positive carcinomas.

Keywords

Oropharyngeal neoplasms Induction chemotherapy Radiochemotherapy Biological markers Human papillomavirus 16 

Literatur

  1. 1.
    Ang KK, Harris J, Wheeler R et al (2010) Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med 363:24–35PubMedCrossRefGoogle Scholar
  2. 2.
    Ang KK, Zhang QE, Rosenthal DI et al (2011) A randomized phase III trial (RTOG 0522) of concurrent accelerated radiation plus cisplatin with or without cetuximab for stage III-IV head and neck squamous cell carcinomas (HNC). ASCO Meeting Abstracts. J Clin Oncol 29 (Suppl): abstr 5500Google Scholar
  3. 3.
    Ang M-K, Ang SH, Krishna SS et al (2012) Association of smoking status with p16 and cyclin D1 (CCND1) expression with clinical characteristics and overall survival (OS) in oropharyngeal squamous cell carcinoma (OSC). ASCO Meeting Abstracts. J Clin Oncol 30 (Suppl): abstr 5551Google Scholar
  4. 4.
    Ang SH, Haaland B, Thu MMM et al (2012) P16 and cyclin D1 (CYD1) as prognostic markers in hypopharyngeal (HSC) and oropharyngeal squamous cell carcinoma (OSC). ASCO Meeting Abstracts. J Clin Oncol 30 (Suppl): abstr 5580Google Scholar
  5. 5.
    Bhatnagar AR, Singh DP, Sharma R et al (2012) A comparative study of monoclonal antibody against EGFR (nimotuzumab) used in combination with chemoradiation versus chemoradiation alone in the treatment of locally advanced inoperable squamous cell carcinoma of the head and neck. ASCO Meeting Abstracts. J Clin Oncol 30 (Suppl): abstr e16012Google Scholar
  6. 6.
    Bonner JA, Harari PM, Giralt J et al (2006) Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Engl J Med 354:567–578PubMedCrossRefGoogle Scholar
  7. 7.
    Bourhis J, Overgaard J, Audry H et al (2006) Hyperfractionated or accelerated radiotherapy in head and neck cancer: a meta-analysis. Lancet 368:843–854PubMedCrossRefGoogle Scholar
  8. 8.
    Boyle JO, Hakim J, Koch W et al (1993) The incidence of p53 mutations increases with progression of head and neck cancer. Cancer Res 53:4477–4480PubMedGoogle Scholar
  9. 9.
    Bynoe MS, Viret C (2008) Foxp3+ CD4+ T cell-mediated immunosuppression involves extracellular nucleotide catabolism. Trends Immunol 29:99–102PubMedCrossRefGoogle Scholar
  10. 10.
    Cohen EEW, Karrison T, Kocherginsky M et al (2012) DeCIDE: A phase III randomized trial of docetaxel (D), cisplatin (P), 5-fluorouracil (F) (TPF) induction chemotherapy (IC) in patients with N2/N3 locally advanced squamous cell carcinoma of the head and neck (SCCHN). ASCO Meeting Abstracts. J Clin Oncol 30 (Suppl): abstr 5500Google Scholar
  11. 11.
    Feldman-Moreno RA, Kemkes AC, Xiu J et al (2012) Differences in biomarker expression in HNSCC according to p53 status. ASCO Meeting Abstracts. J Clin Oncol 30 (Suppl): abstr 5523Google Scholar
  12. 12.
    Giralt J, Fortin A, Mesia R et al (2012) A phase II, randomized trial (CONCERT-1) of chemoradiotherapy (CRT) with or without panitumumab (pmab) in patients (pts) with unresected, locally advanced squamous cell carcinoma of the head and neck (LASCCHN). ASCO Meeting Abstracts. J Clin Oncol 30 (Suppl): abstr 5502CrossRefGoogle Scholar
  13. 13.
    Haddad RI, Rabinowits G, Tishler RB et al (2012) A phase III study comparing sequential therapy (ST) to concurrent chemoradiotherapy (CRT) in locally advanced head and neck cancer (LANHC). ASCO Meeting Abstracts. J Clin Oncol 30 (Suppl): abstr 5501Google Scholar
  14. 14.
    Kim CH (2009) FOXP3 and its role in the immune system. Adv Exp Med Biol 665:17–29PubMedCrossRefGoogle Scholar
  15. 15.
    Li Y, Li L (2012) Intra-arterial infusion of recombinant adenoviral human p53 gene combined chemotherapy for advanced oral cancer: A phase II double-blind randomized clinical trial. ASCO Meeting Abstracts. J Clin Oncol 30 (Suppl): abstr 5507CrossRefGoogle Scholar
  16. 16.
    Lim W-T, Ang M-K, Ng QS et al (2012) A phase II study of nimotuzumab and CDDP concurrent with radiation in locally advanced squamous cell carcinoma of the head and neck (SCCHN). ASCO Meeting Abstracts. J Clin Oncol 30 (Suppl): abstr e16024Google Scholar
  17. 17.
    Lorch JH, Hanna G, Dai W et al (2012) HPV and survival in patients with oropharyngeal squamous cell cancer of the head and neck (OPC) treated with induction chemotherapy followed by chemoradiotherapy (ST) versus chemoradiotherapy alone (CRT): the Dana-Farber experience. ASCO Meeting Abstracts. J Clin Oncol 30 (Suppl): abstr 5582CrossRefGoogle Scholar
  18. 18.
    Lowy DR, Munger K (2010) Prognostic implications of HPV in oropharyngeal cancer. N Engl J Med 363:82–84PubMedCrossRefGoogle Scholar
  19. 19.
    Marur S, Lee J-W, Cmelak A et al (2012) A phase II trial of induction chemotherapy followed by cetuximab with low dose versus standard dose IMRT in patients with HPV-associated resectable squamous cell carcinoma of the oropharynx (OP). ASCO Meeting Abstracts. J Clin Oncol 30 (Suppl): abstr 5566Google Scholar
  20. 20.
    Mehrotra B, Schwartz DL, Frank D et al (2012) Phase II trial of neoadjuvant chemotherapy for HPV-associated squamous cell carcinoma of the oropharynx followed by reduced-dose radiotherapy/chemoradiotherapy for responders or standard dose chemoradiotherapy for nonresponders. ASCO Meeting Abstracts. J Clin Oncol 30 (Suppl): abstr TPS5601Google Scholar
  21. 21.
    Park K, Cho K-J, Yoon DH et al (2012) Importance of HPV involvement and FOXP3+ T-cell status as prognostic factors in tonsilar squamous cell carcinoma. ASCO Meeting Abstracts. J Clin Oncol 30 (Suppl): abstr 5586Google Scholar
  22. 22.
    Posner MR, Lorch JH, Goloubeva O et al (2010) Oropharynx cancer (OPC) in TAX 324: Human papillomavirus (HPV) and survival. ASCO Meeting Abstracts. J Clin Oncol 28 (Suppl): abstr 5525Google Scholar
  23. 23.
    Seiwert TY, Keck MK, Zuo Z et al (2012) Genomic profiling of a clinically annotated cohort of locoregionally advanced head and neck cancers (HNC) treated with definitive chemoradiotherapy. ASCO Meeting Abstracts. J Clin Oncol 30 (Suppl): abstr 5517Google Scholar
  24. 24.
    Shu J (2012) Recombinant adenoviral human p53 gene combined with chemoradiotherapy in treatment of advanced unresectable head and neck cancer. ASCO Meeting Abstracts. J Clin Oncol 30 (Suppl): abstr e16011Google Scholar
  25. 25.
    Sudaka A, Saada E, Natale R et al (2012) Differential expression of EGFR, HER2, P16, and high-risk (hr) HPV status in oropharyngeal (Or) and oral cavity (OC) squamous cell carcinoma (SCC). ASCO Meeting Abstracts. J Clin Oncol 30 (Suppl): abstr 5521Google Scholar
  26. 26.
    Tinhofer I, Boyko-Fabian M, Niehr F et al (2012) The PARP inhibitor olaparib (AZD2281) as potent radiosensitizer of head and neck cancer cells. ASCO Meeting Abstracts. J Clin Oncol 30 (Suppl): abstr e16018Google Scholar
  27. 27.
    Waldron JN, Parulekar W, O’Sullivan B et al (2012) A phase III study of standard fractionation radiotherapy with concurrent high-dose cisplatin versus accelerated fractionation radiotherapy (RT) with panitumumab in patients with locally advanced stage III and IV squamous cell carcinoma of the head and neck (SCCHN) (NCIC Clinical Trials Group HN.6). ASCO Meeting Abstracts. J Clin Oncol 30 (Suppl): abstr TPS5600Google Scholar
  28. 28.
    Whiteside TL (2012) What are regulatory T cells (Treg) regulating in cancer and why? Semin Cancer Biol 22:327–334PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • M. Loewenthal
    • 1
  • E. Vitez
    • 1
  • S. Laban
    • 1
  • A. Münscher
    • 1
  • B. Güldenzoph
    • 2
  • R. Knecht
    • 1
  • C.-J. Busch
    • 1
  1. 1.Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Kopf-Hals-Tumorzentrum des Universitären Cancer Center HamburgUniversitätsklinikum Hamburg-EppendorfHamburgDeutschland
  2. 2.Medizinische Klinik und Poliklinik für Hämatologie und Onkologie, Kopf-Hals-Tumorzentrum des Universitären Cancer Center HamburgUniversitätsklinikum Hamburg-EppendorfHamburgDeutschland

Personalised recommendations