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Induction Chemotherapy for Advanced Oral Cavity Cancer

Abstract

Purpose of Review

Head and neck cancer is a heterogeneous disease, comprising multiple subsites with diverse etiologic factors, pathology and molecular features, response to treatment, and prognosis. Systemic treatment is usually incorporated in the management of locally advanced head and neck squamous cell carcinoma, and the use of induction chemotherapy has theoretical benefits on reducing the risk of distant metastasis, provide an in vivo testing of response and tumor biology and the potential to allow a more personalized and less toxic local treatment after downstaging. The aim of this review is to access the role of induction chemotherapy in patients with locally advanced oral cavity cancer.

Recent Findings

Clinical trials analyzing this treatment strategy in patients with resectable disease, followed by surgery, and in unresectable disease, followed by (chemo)radiotherapy or surgery are discussed, pointing out strengths and limitations of this data and highlighting the standard treatment in each clinical scenario. Future perspectives, including the incorporation of checkpoint inhibitors and biomarkers for patient selection are discussed.

Summary

Surgery followed by (chemo)radiation is the standard of care for resectable oral cavity cancer patients, and chemoradiation is the standard for those considered as unresectable. Future trials with the incorporation of immunotherapy and better patient selection based on clinical and molecular biomarkers can bring new hopes for better therapeutic results in these patients.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Contributions

All authors contributed equally in terms of manuscript writing, interpretation of the data and supported the decision to submit the article for publication.

Corresponding author

Correspondence to Thiago Bueno de Oliveira.

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Conflict of Interest

TBO: received support for his advisory work from pharmaceutical companies including Merck Serono, Merck Sharp and Dohme, Bristol Myers Squibb, Janssen and Bayer. He has also received fees for Speakers’ bureau from Merck Serono, Merck Sharp and Dohme, Bristol Myers Squibb. GNM has no conflicts of interests to declare related to this article. LPK has no conflicts of interests to declare related to this article. GCJ: honoraria from Merck Sharp and Dohme, and Bristol Myers Squibb; advisory/consultancy for Merck Sharp and Dohme, Bristol Myers Squibb, and Merck Serono; speakers bureau/expert testimony for Merck Sharp and Dohme, and Bristol Myers Squibb; research grant/funding to institution from Merck Sharp and Dohme, Bristol Myers Squibb, and Merck Serono; and personal fees for travel/accommodation/expenses from Merck Sharp and Dohme, and Bristol Myers Squibb.

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de Oliveira, T.B., Marta, G.N., de Castro Junior, G. et al. Induction Chemotherapy for Advanced Oral Cavity Cancer. Curr Oncol Rep 23, 129 (2021). https://doi.org/10.1007/s11912-021-01119-6

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  • DOI: https://doi.org/10.1007/s11912-021-01119-6

Keywords

  • Oral cavity
  • Neoplasms
  • Treatment
  • Induction chemotherapy
  • Surgery
  • Radiotherapy