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Medikamentöse Therapie des Oropharynxkarzinoms

Medicinal tumor treatment of oropharyngeal cancer

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Zusammenfassung

Hintergrund

In den letzten Dekaden nimmt die Zahl der Patienten zu, die an einem mit humanem Papillomavirus 16 (HPV16-)assoziierten Oropharynxkarzinom (OPSCC) leiden. Bis heute ist die Rolle der medikamentösen Therapie der Patienten mit Plattenepithelkarzinom im Kopf-Hals-Bereich nur in der refraktären oder metastasierten Situation (r/m-HNSCC) etabliert.

Fragestellung

Wie sieht die aktuelle Therapielandschaft der Patienten mit r/m-HNSCC bzw. r/m-OPSCC aus?

Material und Methoden

Es erfolgte eine Literaturrecherche zur Systemtherapie des OPSCC und r/m-HNSCC.

Ergebnisse

Bis dato ist keine gesonderte Standardtherapie für Patienten mit OPSCC im refraktären oder metastasierten Stadium vorhanden. Seit 2017 gewinnt die Immuntherapie mit Checkpointinhibitoren immer mehr an Bedeutung bei der Behandlung der r/m-HNSCC-Patienten. Zuletzt wurde die Erstlinientherapie aufgrund der KEYNOTE-048(KN048)-Studienergebnisse angepasst. Für einen Teil der Patienten mit r/m-HNSCC steht nun eine „chemotherapiefreie“ Therapieoption zur Verfügung. In der nahen Zukunft ist auch der Einsatz der Immuntherapie in früheren Stadien der HNSCC zu erwarten.

Schlussfolgerung

Die medikamentöse Therapie der r/m-HNSCC-Patienten ist im großen Wandel und erfolgt zunehmend basiert auf der Kombinationstherapie mit Immuncheckpointinhibitoren.

Abstract

Background

The number of patients suffering from human papillomavirus (HPV)-associated oropharyngeal cancer has increased in recent decades. To date, the role of medical therapy in patients with squamous cell carcinoma of the head and neck region has only been established in the refractory or metastatic setting (r/m HNSCC).

Objective

What are the current treatment options for patients with r/m HNSCC or r/m oropharyngeal cancer?

Materials and methods

A literature search was conducted on systemic treatment of oropharyngeal cancer and r/m HNSCC.

Results

There is currently no standard treatment for patients with oropharyngeal cancer in refractory or metastatic stages. Since 2017, immunotherapy with checkpoint inhibitors has become increasingly important in the treatment of r/m HNSCC patients. First-line therapy was recently adapted based on the results of the KEYNOTE-48 (KN048) study. For selected patients with r/m HNSCC, there now exists a chemotherapy-free treatment option. Use of immunotherapy also in earlier stages of HNSCC can be expected in the near future.

Conclusion

Medical therapy of r/m HNSCC patients is in a period of great change. Treatment is increasingly based on combination therapy with checkpoint inhibitors.

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Authors and Affiliations

  1. Klinik für Innere Medizin, Hämatologie, Onkologie und Stammzelltransplantation, Universitätsklinikum Freiburg, Freiburg, Deutschland

    J. Rawluk & C. F. Waller

  2. Fakultät für Medizin, Universität Freiburg, Freiburg, Deutschland

    J. Rawluk & C. F. Waller

  3. Klinik für Innere Medizin I, Universitätsklinikum Freiburg, Hugstetterstraße 55, 79106, Freiburg, Deutschland

    J. Rawluk

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Correspondence to J. Rawluk.

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Interessenkonflikt

J. Rawluk: Honorare für Vorträge und Beratung von: Astra Zeneca, Boehringer Ingelheim, BMS, Chugai, Roche, MSD, Takeda; C.F. Waller: Honorare für Vorträge und Beratung von Astra Zeneca, Boehringer Ingelheim, BMS, Chugai, Lilly, Novartis, Pfizer, Roche, Takeda; Mylan; Alvotech, Travel Grants: MSD, IPSEN, BMS.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Rawluk, J., Waller, C.F. Medikamentöse Therapie des Oropharynxkarzinoms. HNO 69, 285–297 (2021). https://doi.org/10.1007/s00106-021-01011-6

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  • DOI: https://doi.org/10.1007/s00106-021-01011-6

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