Advertisement

Bedeutung der adjuvanten und palliativen Chemotherapie – inklusive Immuntherapie

Rolle der medikamentösen Tumortherapie beim Kopf-Hals-Karzinom
  • Viktor GrünwaldEmail author
Leitthema
  • 21 Downloads

Zusammenfassung

Hintergrund

Die Systemtherapie des rezidivierten bzw. metastasierten Kopf-Hals-Plattenepithelkarzinoms (RM-SCCHN) ist aktuell im Wandel. Neben Chemotherapie und Inhibitoren des epidermalen Wachstumsfaktorrezeptors (EGFR) stehen mittlerweile auch Checkpointinhibitoren (CPI) in der Klinik zur Verfügung.

Fragestellung

Wie fügen sich die aktuellen Daten in die Behandlungsrealität des RM-SCCHN ein?

Material und Methoden

Es erfolgte eine Literaturrecherche zur Systemtherapie des RM-SCCHN.

Ergebnisse

CPI sind ein Standard bei der Behandlung nach Platin-Versagen beim RM-SCCHN. Aktuelle Studien belegen den Stellenwert dieser neuen Therapieoption in der Erstlinie und werden in Kürze zu einem Umdenken in der Behandlungsrealität führen.

Schlussfolgerung

CPI sind das Rückgrat der Systemtherapie des RM-SCCHN und werden sich zukünftig auch in frühen Stadien der Behandlung wiederfinden.

Schlüsselwörter

Kopf-Hals-Karzinom Rezidiv Metastasen Epidermaler Wachstumsfaktorrezeptor Checkpointinhibitor-Therapie 

Importance of adjuvant and palliative chemotherapy – including immunotherapy

The role of medicinal tumor treatment in carcinomas of the head and neck

Abstract

Background

The systemic treatment of recurrent or metastatic squamous cell carcinoma of the head and neck (RM-SCCHN) is currently undergoing a change in direction. In addition to chemotherapy and inhibitors of the epidermal growth factor receptor (EGFR), checkpoint inhibitors (CPI) are now available for clinical treatment.

Research question

How do the current data fit into the treatment reality of RM-SCCHN?

Material and methods

A literature search on the topic of systemic treatment of RM-SCCHN was carried out.

Results

The CPIs are the standard treatment after failure of platinum treatment of RM-SCCHN. Currently available studies confirmed the importance of this new therapeutic option in the first line setting and will soon lead to a change of the treatment reality.

Conclusion

The use of CPIs is the backbone of the systemic therapy of RM-SCCHN and they are also candidates for medicinal treatment in the early stages in the future.

Keywords

Head and neck neoplasms Recurrence Metastases Epidermal growth factor receptor Checkpoint inhibitor therapy 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

V. Grünwald gibt folgende Interessenkonflikte an: Honorare für Sprecher und Beratertätigkeiten: Art tempi, AstraZeneca, Astellas, BMS, Cerulean, COCS, ClinSol, EUSAPharm, EISAI, Ipsen, MedUpdate, Merck Serono, MSD Merck, MedKomAkademie, Novartis, NewConceptOncology, Lilly, Johnson & Johnson, PharmaMar, PeerVoice, Roche, StreamedUp!, ThinkWired! Forschungsförderung: BMS, Novartis, EISAI, Pfizer, MSD, AstraZeneca, Roche, Ipsen. Aktien: AstraZeneca, BMS, MSD.

Dieser Beitrag beinhaltet keine vom Autor durchgeführten Studien an Menschen oder Tieren.

Literatur

  1. 1.
    Argiris A, Ghebremichael M, Gilbert J et al (2013) Phase III randomized, placebo-controlled trial of Docetaxel with or without Gefitinib in recurrent or metastatic head and neck cancer: an eastern cooperative oncology group trial. J Clin Oncol 31:1405–1414.  https://doi.org/10.1200/JCO.2012.45.4272 CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Bossi P, Miceli R, Locati LD et al (2017) A randomized, phase 2 study of cetuximab plus cisplatin with or without paclitaxel for the first-line treatment of patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck. Ann Oncol 28:2820–2826.  https://doi.org/10.1093/annonc/mdx439 CrossRefPubMedGoogle Scholar
  3. 3.
    Burtness B, Harrington KJ, Greil R et al (2018) LBA8_PRKEYNOTE-048: Phase III study of first-line pembrolizumab (P) for recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). Ann Oncol.  https://doi.org/10.1093/annonc/mdy424.045 CrossRefGoogle Scholar
  4. 4.
    Cohen E, Harrington KJ, Le Tourneau C, Oncol JDA (2017) Pembrolizumab versus standard of care for recurrent or metastatic head and neck squamous cell carcinoma: phase 3 KEYNOTE-040 trial. ESMO Meeting LBA45.Google Scholar
  5. 5.
    Das LC, Karrison TG, Witt ME et al (2015) Comparison of outcomes of locoregionally advanced oropharyngeal and non-oropharyngeal squamous cell carcinoma over two decades. Ann Oncol 26:198–205.  https://doi.org/10.1093/annonc/mdu511 CrossRefPubMedGoogle Scholar
  6. 6.
    Ferris RL, Blumenschein G, Fayette J et al (2016) Nivolumab for recurrent squamous-cell carcinoma of the head and neck. N Engl J Med.  https://doi.org/10.1056/NEJMoa1602252 CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Forastiere AA, Metch B, Schuller DE et al (1992) Randomized comparison of cisplatin plus fluorouracil and carboplatin plus fluorouracil versus methotrexate in advanced squamous-cell carcinoma of the head and neck: a Southwest Oncology Group study. J Clin Oncol 10:1245–1251CrossRefGoogle Scholar
  8. 8.
    Ghosh-Laskar S, Yathiraj PH, Dutta D et al (2016) Prospective randomized controlled trial to compare 3‑dimensional conformal radiotherapy to intensity-modulated radiotherapy in head and neck squamous cell carcinoma: long-term results. Head Neck 38(Suppl 1):E1481–E1487.  https://doi.org/10.1002/hed.24263 CrossRefPubMedGoogle Scholar
  9. 9.
    Grose WE, Lehane DE, Dixon DO et al (1985) Comparison of methotrexate and cisplatin for patients with advanced squamous cell carcinoma of the head and neck region: a Southwest Oncology Group Study. Cancer Treat Rep 69:577–581PubMedGoogle Scholar
  10. 10.
    Guigay J, Fayette J, Dillies AF et al (2015) Cetuximab, docetaxel, and cisplatin as first-line treatment in patients with recurrent or metastatic head and neck squamous cell carcinoma: a multicenter, phase II GORTEC study. Ann Oncol 26:1941–1947.  https://doi.org/10.1093/annonc/mdv268 CrossRefPubMedGoogle Scholar
  11. 11.
    Jacobs C, Lyman G, Velez-García E et al (1992) A phase III randomized study comparing cisplatin and fluorouracil as single agents and in combination for advanced squamous cell carcinoma of the head and neck. J Clin Oncol 10:257–263.  https://doi.org/10.1200/JCO.1992.10.2.257 CrossRefPubMedGoogle Scholar
  12. 12.
    Janot F, de Raucourt D, Benhamou E et al (2008) Randomized trial of postoperative reirradiation combined with chemotherapy after salvage surgery compared with salvage surgery alone in head and neck carcinoma. J Clin Oncol 26:5518–5523.  https://doi.org/10.1200/JCO.2007.15.0102 CrossRefPubMedGoogle Scholar
  13. 13.
    Joseph AW, Guo T, Hur K et al (2016) Disease-free survival after salvage therapy for recurrent oropharyngeal squamous cell carcinoma. Head Neck 38(Suppl 1):E1501–E1509.  https://doi.org/10.1002/hed.24268 CrossRefPubMedGoogle Scholar
  14. 14.
    Knoedler M, Gauler T, Dietz A et al (2014) Cetuximab (c), Fluorouracil (f) and Cisplatin (p) alone or with Docetaxel (d) for Recurrent/Metastatic (rm) Head And Neck Cancer (hnscc). Final analysis of aio trial # 1108 – CEFCID. Ann Oncol 25:iv340–iv340.  https://doi.org/10.1093/annonc/mdu340.2 CrossRefGoogle Scholar
  15. 15.
    Knoedler M, Gauler TC, Gruenwald V et al (2013) Phase II study of Cetuximab in combination with Docetaxel in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck after platinum-containing therapy: a Multicenter study of the Arbeitsgemeinschaft Internistische Onkologie. Oncology 84:284–289.  https://doi.org/10.1159/000345453 CrossRefPubMedGoogle Scholar
  16. 16.
    León X, Hitt R, Constenla M et al (2005) A retrospective analysis of the outcome of patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck refractory to a platinum-based chemotherapy. Clin Oncol (r Coll Radiol) 17:418–424CrossRefGoogle Scholar
  17. 17.
    Machiels J‑P, Subramanian S, Ruzsa A et al (2011) Zalutumumab plus best supportive care versus best supportive care alone in patients with recurrent or metastatic squamous-cell carcinoma of the head and neck after failure of platinum-based chemotherapy: an open-label, randomised phase 3 trial. Lancet Oncol 12:333–343.  https://doi.org/10.1016/S1470-2045(11)70034-1 CrossRefPubMedGoogle Scholar
  18. 18.
    Machiels J‑PH, Haddad RI, Fayette J et al (2015) Afatinib versus methotrexate as second-line treatment in patients with recurrent or metastatic squamous-cell carcinoma of the head and neck progressing on or after platinum-based therapy (LUX-Head & Neck 1): an open-label, randomised phase 3 trial. Lancet Oncol 16:583–594.  https://doi.org/10.1016/S1470-2045(15)70124-5 CrossRefPubMedGoogle Scholar
  19. 19.
    de Martel C, Plummer M, Vignat J, Franceschi S (2017) Worldwide burden of cancer attributable to HPV by site, country and HPV type. Int J Cancer 141:664–670.  https://doi.org/10.1002/ijc.30716 CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Soulieres D, Faivre S, Mesia R et al (2017) Buparlisib and paclitaxel in patients with platinum-pretreated recurrent or metastatic squamous cell carcinoma of the head and neck (BERIL-1): a randomised, double-blind, placebo-controlled phase 2 trial. Lancet Oncol 18:323–335.  https://doi.org/10.1016/S1470-2045(17)30064-5 CrossRefPubMedGoogle Scholar
  21. 21.
    Spencer SA, Harris J, Wheeler RH et al (2008) Final report of RTOG 9610, a multi-institutional trial of reirradiation and chemotherapy for unresectable recurrent squamous cell carcinoma of the head and neck. Head Neck 30:281–288.  https://doi.org/10.1002/hed.20697 CrossRefPubMedGoogle Scholar
  22. 22.
    Stewart JSW, Cohen EEW, Licitra L et al (2009) Phase III study of gefitinib compared with intravenous methotrexate for recurrent squamous cell carcinoma of the head and neck [corrected]. J Clin Oncol 27:1864–1871.  https://doi.org/10.1200/JCO.2008.17.0530 CrossRefPubMedGoogle Scholar
  23. 23.
    Tinhofer I, Jöhrens K, Keilholz U et al (2015) Contribution of human papilloma virus to the incidence of squamous cell carcinoma of the head and neck in a European population with high smoking prevalence. Eur J Cancer 51:514–521.  https://doi.org/10.1016/j.ejca.2014.12.018 CrossRefPubMedGoogle Scholar
  24. 24.
    Vermorken JB, Mesia R, Rivera F et al (2008) Platinum-based chemotherapy plus cetuximab in head and neck cancer. N Engl J Med 359:1116–1127.  https://doi.org/10.1056/NEJMoa0802656 CrossRefPubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Westdeutsches Tumorzentrum, Schwerpunkt interdisziplinäre UroonkologieUniversitätsklinikum EssenEssenDeutschland

Personalised recommendations