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Mahdavi H. Induction chemotherapy in locally advanced head and neck cancers, is there a best choice? Crit Rev Oncol Hematol 2023; 186:103986. [PMID: 37059273 DOI: 10.1016/j.critrevonc.2023.103986] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/25/2023] [Accepted: 04/11/2023] [Indexed: 04/16/2023] Open
Abstract
Locally advanced stages of squamous cancers of the head and neck (LAHNCs) acquire high propensity for local and systemic relapse. Addition of systemic therapy as an induction (IC) to the standard concurrent chemoradiotherapy (CCRT) has become an approach of many practitioners. This strategy has shown to reduce metastases but did not affect survival in unselected populations. Meanwhile, the induction regimen including docetaxel, cisplatin, 5-FU (TPF) has shown superiority over other combinations, however, a survival advantage was not detected when compared to CCRT alone. This may be attributed to its high toxicity profile, inducing treatment delay, resistance, or variations in tumor sites and responses. Currently, newer systemic therapy combinations are being tested and indicators of benefit are being identified. The focus of this review is on the development of the choice of combination regimen for induction. Subsequently, proposed alternatives and strategies for patient selection will be introduced.
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Affiliation(s)
- Hoda Mahdavi
- Department of Radiation Oncology, School of Medicine, Iran University of Medical Sciences,Tehran, Iran; Department of Radiation Oncology, Firoozgar General Hospital, Beh-Afarin St., Karimkhan-e-Zand Ave., Vali-e-Asr Sq., Tehran, Iran.
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2
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Murr AT, Lenze NR, Weiss JM, Grilley-Olson JE, Patel SA, Shen C, Chera BS, Zanation AM, Thorp BD, Sheth SH. Sinonasal Squamous Cell Carcinoma Survival Outcomes Following Induction Chemotherapy vs Standard of Care Therapy. Otolaryngol Head Neck Surg 2022; 167:846-851. [PMID: 35259033 PMCID: PMC9630958 DOI: 10.1177/01945998221083097] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective To compare oncologic outcomes in sinonasal squamous cell carcinoma (SNSCC)
treated with standard of care (SOC) definitive therapy, consisting of
surgery or chemoradiotherapy, vs induction therapy followed by definitive
therapy. Study Design Retrospective review. Setting Academic tertiary care hospital. Methods The medical records of patients with biopsy-proven SNSCC treated between 2000
and 2020 were reviewed for demographics, tumor characteristics, staging,
treatment details, and oncologic outcomes. Patients were matched 1-to-1 by
age, sex, and cancer stage according to treatment received. Time-to-event
analyses were conducted. Results The analysis included 26 patients with locally advanced SNSCC who received
either induction therapy (n = 13) or SOC (n = 13). Baseline demographics,
Charlson Comorbidity Index, and median follow-up time were well balanced.
Weekly cetuximab, carboplatin, and paclitaxel were the most common induction
regimen utilized. Tolerance and safety to induction were excellent.
Objective responses were observed in 11 of 13 patients receiving induction.
No difference in disease-free survival was found between the induction and
SOC groups at 1 or 3 years. However, when compared with SOC, induction
therapy resulted in significant improvement in overall survival at 2 years
(100% vs 65.3%, P = .043) and 3 years (100% vs 48.4%,
P = .016) following completion of definitive therapy.
Two patients in the SOC group developed metastatic disease, as compared with
none in the induction group. Conclusions Induction therapy was safe and effective. When compared with SOC, induction
therapy improved 3-year overall survival.
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Affiliation(s)
- Alexander T Murr
- Department of Otolaryngology-Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Nicholas R Lenze
- Department of Otolaryngology-Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jared M Weiss
- Division of Medical Oncology, Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Juneko E Grilley-Olson
- Division of Medical Oncology, Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Shetal A Patel
- Division of Medical Oncology, Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Colette Shen
- Department of Radiation Oncology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Bhishamjit S Chera
- Department of Radiation Oncology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Adam M Zanation
- Department of Otolaryngology-Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brian D Thorp
- Department of Otolaryngology-Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Siddharth H Sheth
- Division of Medical Oncology, Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Wang CC, Lin WJ, Liu YC, Chen CC, Wu SH, Liu SA, Liang KL. Transoral Robotic Surgery for Pharyngeal and Laryngeal Cancers-A Prospective Medium-Term Study. J Clin Med 2021; 10:jcm10050967. [PMID: 33801167 PMCID: PMC7957508 DOI: 10.3390/jcm10050967] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 01/13/2023] Open
Abstract
Transoral robotic surgery (TORS) has been used for treating pharyngeal and laryngeal cancers for many years. However, the application of neoadjuvant chemotherapy (NACT) before TORS, the sparing rate of adjuvant irradiation after TORS, and the long-term oncologic/functional outcomes of TORS are seldom reported. From September 2014 to May 2018, 30 patients with clinical T1 to T3 cancers of oropharynx (7), larynx (3), and hypopharynx (20) were prospectively recruited for TORS in a tertiary referral medical center. Twelve (40%) patients had clinical early stage (I or II) disease, and 18 (60%) patients had late-stage (III or IV) disease. All 30 patients were suggested to receive TORS with neck dissection. Cisplatin-based NACT was given to 11 patients before the surgery, and it led to a 100% reduction in tumor size. Only 40% of patients needed adjuvant irradiation with a mean dosage of 5933 cGY after TORS. After a mean follow up of 38.9± 14.7 months, the Kaplan-Meier method estimated 5-year disease-specific survival, and organ preservation was 86.3% and 96.2%, respectively. Twenty-five patients were alive without tracheostomy and tube feeding. We found that NACT is a potential method for facilitating tumor resection and TORS effectively de-escalated adjuvant irradiation with a satisfactory 5-year survival and functional outcomes.
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Affiliation(s)
- Chen-Chi Wang
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (Y.-C.L.); (S.-A.L.); (K.-L.L.)
- School of Speech Language Pathology & Audiology, Chung Shan Medical University, Taichung 40121, Taiwan
- Department of Audiology and Speech-Language Pathology, Asia University, Taichung 41354, Taiwan
- Department of Otolaryngology-Head & Neck Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (W.-J.L.); (S.-H.W.)
- Correspondence: ; Tel.: +886-4-23592525 (ext. 83601)
| | - Wen-Jiun Lin
- Department of Otolaryngology-Head & Neck Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (W.-J.L.); (S.-H.W.)
| | - Yi-Chun Liu
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (Y.-C.L.); (S.-A.L.); (K.-L.L.)
- Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - Chien-Chih Chen
- Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
- Ph. D. Program in Translational Medicine, National Chung-Hsing University, Taichung 40227, Taiwan
| | - Shang-Heng Wu
- Department of Otolaryngology-Head & Neck Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (W.-J.L.); (S.-H.W.)
| | - Shih-An Liu
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (Y.-C.L.); (S.-A.L.); (K.-L.L.)
- Department of Otolaryngology-Head & Neck Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (W.-J.L.); (S.-H.W.)
| | - Kai-Li Liang
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (Y.-C.L.); (S.-A.L.); (K.-L.L.)
- Department of Otolaryngology-Head & Neck Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (W.-J.L.); (S.-H.W.)
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Kondo T, Tsukahara K, Okamoto I, Sato H, Okada T, Maruyama R, Hihara K, Ito T, Takeda A, Kikawada N, Aihara Y, Ogawa Y. Predicting the efficacy of chemoradiotherapy for locally advanced human papilloma virus-related oropharyngeal squamous cell carcinoma using one course of TPF chemotherapy. Eur Arch Otorhinolaryngol 2021; 278:3497-3506. [PMID: 33386967 DOI: 10.1007/s00405-020-06549-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 12/04/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The standard induction chemotherapy for head and neck cancer is TPF [cisplatin (CDDP), docetaxel (DOC), and 5-fluorouracil (5-FU)]. We assessed whether one course of TPF could predict the efficacy of chemoradiotherapy for human papilloma virus (HPV)-related oropharyngeal squamous cell carcinoma. METHODS We retrospectively reviewed 51 patients with stage III-IV HPV-related oropharyngeal squamous cell carcinoma who received one course of TPF with CDDP 60 mg/m2, DOC 60 mg/m2, and 5-FU 600 mg/m2. We recommended chemoradiotherapy for patients with complete or partial response (CR/PR), and surgery for those with stable or progressive disease (SD/PD). The endpoints were TPF-related adverse events and efficacy, chemoradiotherapy efficacy, and 2-year survival. RESULTS Neutropenia was the most common grade ≥ 3 adverse event (88%). No grade 5 adverse events occurred. TPF achieved CR in 4% of patients (2/51), PR in 73% (37/51), SD in 20% (10/51), and PD in 4% (2/51). Concurrent cetuximab and radiotherapy (bio-radiotherapy, BRT) were administered to 61% of patients (31/51), concurrent CDDP and radiotherapy (CDDP-RT) to 16% (8/51), RT alone to 2% (1/51), and surgery was performed for 22% (11/51). CR was achieved in 85% of the chemoradiotherapy group, and the rate tended to increase with TPF efficacy. CR was achieved in 84% (26/31) of patients receiving BRT, 88% (7/8) receiving CDDP-RT, and 100% (1/1) receiving RT. The 2-year survival rates were 92% overall, and 97% and 79% in the chemoradiotherapy and surgery groups, respectively. CONCLUSIONS When facing difficulty in deciding between chemoradiotherapy and surgery, one course of TPF may be an effective option.
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Affiliation(s)
- Takahito Kondo
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo, 193-0998, Japan.
| | - Kiyoaki Tsukahara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Isaku Okamoto
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Hiroki Sato
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Takuro Okada
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Ryo Maruyama
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Kosuke Hihara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Tatsuya Ito
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Atsuo Takeda
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo, 193-0998, Japan
| | - Naiue Kikawada
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo, 193-0998, Japan
| | - Yusuke Aihara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo, 193-0998, Japan
| | - Yasuo Ogawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo, 193-0998, Japan
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Farrell NF, Mace JC, Detwiller KY, Li R, Andersen PE, Smith TL, Clayburgh DR, Geltzeiler M. Predictors of survival outcomes in sinonasal squamous cell carcinoma: an analysis of the National Cancer Database. Int Forum Allergy Rhinol 2020; 11:1001-1011. [PMID: 33226198 DOI: 10.1002/alr.22737] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/10/2020] [Accepted: 10/02/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Sinonasal squamous cell carcinoma (SNSCC) is a rare malignancy that poses management challenges. Although surgery and chemoradiation therapy (CRT) remain therapeutic mainstays, induction chemotherapy (IC) has emerged as a useful adjunct with locally advanced disease. This study used the National Cancer Data Base (NCDB) to examine treatment outcomes for patients diagnosed with SNSCC. METHODS The NCDB (2004-2015) was queried for cases with SNSCC. Multivariate hazard regression modeling was used to identify significant predictors of 24-month and 60-month overall survival (OS) including treatment modality. RESULTS A total of 3516 patients with SNSCC met inclusion criteria, including 1750 patients (49.8%) treated with surgery ± adjuvant therapy, 1352 (38.5%) treated with definitive radiotherapy (RT) or CRT, 300 (8.5%) who underwent IC followed by definitive CRT, and 114 (3.2%) who received IC followed by surgery and adjuvant therapy. Hazard modeling for confirmed treatment modality significantly associated (p < 0.001) with OS after adjustment. Patients who received surgical intervention ± adjuvant therapy had lower 24-month and 60-month mortality risk compared to definitive RT or CRT (hazard ratio [HR] ≥ 1.97; p < 0.001) or IC followed by definitive CRT (HR ≥ 1.73; p < 0.001). Compared to primary surgery ± adjuvant therapy, patients undergoing IC then surgery had similar 24-month and 60-month OS (p ≥ 0.672) after adjustment. CONCLUSION Multimodality therapy, including surgical intervention, associates with improved OS after multifactorial adjustments. IC followed by surgery associated with improved OS compared to IC, followed by CRT and CRT alone. Study results highlight the utility of surgery toward optimizing OS in patients with SNSCC and demonstrates the potential utility of IC when primary surgical management is not preferred.
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Affiliation(s)
- Nyssa Fox Farrell
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Sinus Surgery, Oregon Health and Science University, Portland, OR
| | - Jess C Mace
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Sinus Surgery, Oregon Health and Science University, Portland, OR
| | - Kara Y Detwiller
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Sinus Surgery, Oregon Health and Science University, Portland, OR.,Portland Veterans Affairs Health Care System, Portland, OR
| | - Ryan Li
- Department of Otolaryngology-Head and Neck Surgery, Division of Head and Neck Surgery, Oregon Health and Science University, Portland, OR
| | - Peter E Andersen
- Department of Otolaryngology-Head and Neck Surgery, Division of Head and Neck Surgery, Oregon Health and Science University, Portland, OR
| | - Timothy L Smith
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Sinus Surgery, Oregon Health and Science University, Portland, OR
| | - Daniel R Clayburgh
- Portland Veterans Affairs Health Care System, Portland, OR.,Department of Otolaryngology-Head and Neck Surgery, Division of Head and Neck Surgery, Oregon Health and Science University, Portland, OR
| | - Mathew Geltzeiler
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Sinus Surgery, Oregon Health and Science University, Portland, OR
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6
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Hsieh CY, Lein MY, Yang SN, Wang YC, Lin YJ, Lin CY, Hua CH, Tsai MH, Lin CC. Dose-dense TPF induction chemotherapy for locally advanced head and neck cancer: a phase II study. BMC Cancer 2020; 20:832. [PMID: 32873270 PMCID: PMC7465725 DOI: 10.1186/s12885-020-07347-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 08/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Phase 3 studies suggest that induction chemotherapy (ICT) of cisplatin and 5-fluorouracil plus docetaxel (TPF) is effective but toxic for patients with squamous-cell carcinoma of the head and neck (SCCHN). Dose-dense chemotherapy may yield favorable outcomes compared with standard-dose chemotherapy, yet the optimal induction regimen remains undefined. We assessed the efficacy and tolerability of biweekly dose-dense TPF ICT in patients with SCCHN. METHODS In this prospective phase II study, We enrolled patients with stage III/IV (AJCC 7th edition) unresectable squamous cell carcinoma of head and neck cancer. Patients received dose-dense TPF (ddTPF) with cisplatin and docetaxel 50 mg/m2 on day 1, leucovorin 250 mg/m2 on day1, followed by 48-h continuous infusion of 2500 mg/m2 of 5-fluorouracil on day 1 and 2, every 2 weeks for 6 cycles followed by radiotherapy. The primary endpoint was the response rate (RR) after ICT. RESULTS Fifty-eight patients were enrolled from June 2014 to September 2015. Overall RR after ICT was 89.6% [complete response (CR), 31%; partial response (PR), 58.6%]. Grade 3/4 neutropenia, mucositis, and diarrhea incidences were 25.9, 1.7, and 1.7%, respectively. 94.8% of patients completed all treatment courses of ICT without dose reduction. The 3-year overall survival (OS) was 54.3% (95%CI: 39.7 to 66.8%) and progression-free survival (PFS) was 34.3% (95%CI: 22.0 to 46.9%). Multivariate analysis showed that CR after ICT is an independent prognostic factor for OS and PFS. CONCLUSIONS Six cycles of ddTPF is an active, well-tolerated induction regimen for patients with SCCHN. The presence of CR after ICT predicted long-term survival. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04397341 , May 21, 2020, retrospectively registered.
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Affiliation(s)
- Ching-Yun Hsieh
- Division of Hematology and Oncology, Department of internal medicine, China Medical University Hospital, China Medical University, 2 Yude Rd, North District, Taichung, 404, Taiwan
| | - Ming-Yuh Lein
- Division of Hematology and Oncology, Department of internal medicine, China Medical University Hospital, China Medical University, 2 Yude Rd, North District, Taichung, 404, Taiwan
| | - Shih-Neng Yang
- Division of Radiation Oncology, China Medical University Hospital, China Medical University, Taichung, 404, Taiwan
| | - Yao-Ching Wang
- Division of Radiation Oncology, China Medical University Hospital, China Medical University, Taichung, 404, Taiwan
| | - Yin-Jun Lin
- Division of Radiation Oncology, China Medical University Hospital, China Medical University, Taichung, 404, Taiwan
| | - Chen-Yuan Lin
- Division of Hematology and Oncology, Department of internal medicine, China Medical University Hospital, China Medical University, 2 Yude Rd, North District, Taichung, 404, Taiwan
| | - Chun-Hung Hua
- Department of Otorhinolaryngology, China Medical University Hospital, China Medical University, Taichung, 404, Taiwan
| | - Ming-Hsul Tsai
- Department of Otorhinolaryngology, China Medical University Hospital, China Medical University, Taichung, 404, Taiwan
| | - Ching-Chan Lin
- Division of Hematology and Oncology, Department of internal medicine, China Medical University Hospital, China Medical University, 2 Yude Rd, North District, Taichung, 404, Taiwan. .,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, 404, Taiwan.
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Stafford M, Kaczmar J. The neoadjuvant paradigm reinvigorated: a review of pre-surgical immunotherapy in HNSCC. CANCERS OF THE HEAD & NECK 2020; 5:4. [PMID: 32195008 PMCID: PMC7077151 DOI: 10.1186/s41199-020-00052-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 03/04/2020] [Indexed: 12/15/2022]
Abstract
Background There remains up to a 50% recurrence rate in advanced p16- head and neck squamous cell carcinoma with current standard of care treatment. In an attempt to improve survival, multiple trials administering induction or neoadjuvant chemotherapy have been conducted but none demonstrated improved overall survival. The established efficacy of immune checkpoint inhibitors in the recurrent and metastatic setting has produced widespread interest in their neoadjuvant use. Purpose To survey the landscape of active neoadjuvant immunotherapy trials in head and neck squamous cell carcinoma and summarize and synthesize currently available outcomes from these trials. Conclusions Neoadjuvant immunotherapy has proven safe and well tolerated in head and neck squamous cell carcinoma with encouraging efficacy results, including relatively high rates of pathologic response. Ongoing studies offer an opportunity to study immune responses in vivo. PD-L1 positivity, high tumor mutational burden and infiltration of NK cells, CD8, CD26 and Tim3 positive lymphocytes at time of surgery have been correlated with pathologic responses. We await updated reports of disease free survival and overall survival data and results of ongoing phase III studies utilizing neoadjuvant immunotherapy to determine if this treatment paradigm will have a place in the standard of care treatment in head and neck squamous cell carcinoma.
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Affiliation(s)
- Margaret Stafford
- Division of Hematology and Oncology, Medical University of South Carolina, 39 Sabin Street, MSC 635, Charleston, SC 29425 USA
| | - John Kaczmar
- Division of Hematology and Oncology, Medical University of South Carolina, 39 Sabin Street, MSC 635, Charleston, SC 29425 USA
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Ledinsky Opačić I, Gršić K, Šitić S, Penavić I, Pastorčić Grgić M, Šarčević B. POSITIVE EXPRESSION OF NEDD9 IN HEAD AND NECK CANCER IS RELATED TO BETTER SURVIVAL PERIOD. Acta Clin Croat 2019; 58:655-661. [PMID: 32595251 PMCID: PMC7314307 DOI: 10.20471/acc.2019.58.04.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The aim was to determine immunohistochemical expression of NEDD9 protein in head and neck squamous cell carcinoma (HNSCC) and the possible relation of its expression with primary tumor size (T), regional lymph node status (N), stage of disease (TNM) and survival period. A total of 131 patients with primary tumor localization in the area of oropharynx, hypopharynx and larynx, monitored for at least 5 years after initial surgical treatment were analyzed. The study included 128 male and three female patients, median age 62.0 (range 53.0-68.0) years. Of these, 105 (95%) patients showed positive NEDD9 expressed by dyed cytoplasm. There were no significant differences in NEDD9 expression according to TNM tumor status. Patients with positive NEDD9 expression had a significantly higher median (IQR) survival time 51.0 (15.0-60.0) months as compared to 22.5 (9.0-55.0) months in patients with negative NEDD9 expression (p=0.048). NEDD9 negative expression, controlled for the influence of other variables included in the Cox’s proportional hazards model, had a significant hazard ratio (HR) of 2.10 (95% CI: 1.23-3.58; p=0.006). The results of our study showed that NEDD9 expression might be an independent prognostic marker in patients with HNSCC regarding data on overall survival and mortality.
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Affiliation(s)
| | - Krešimir Gršić
- 1Division of Head and Neck Surgery, Department of Surgical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Otorhinolaryngology and Head and Neck Surgery, Zagreb University Hospital Centre, Zagreb, Croatia; 3Department of Pathology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 4Department of Surgical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Sanda Šitić
- 1Division of Head and Neck Surgery, Department of Surgical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Otorhinolaryngology and Head and Neck Surgery, Zagreb University Hospital Centre, Zagreb, Croatia; 3Department of Pathology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 4Department of Surgical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Ivan Penavić
- 1Division of Head and Neck Surgery, Department of Surgical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Otorhinolaryngology and Head and Neck Surgery, Zagreb University Hospital Centre, Zagreb, Croatia; 3Department of Pathology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 4Department of Surgical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Marija Pastorčić Grgić
- 1Division of Head and Neck Surgery, Department of Surgical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Otorhinolaryngology and Head and Neck Surgery, Zagreb University Hospital Centre, Zagreb, Croatia; 3Department of Pathology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 4Department of Surgical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Božena Šarčević
- 1Division of Head and Neck Surgery, Department of Surgical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Otorhinolaryngology and Head and Neck Surgery, Zagreb University Hospital Centre, Zagreb, Croatia; 3Department of Pathology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 4Department of Surgical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
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Bossi P, Seront E, Machiels JP. May we rely on induction chemotherapy again as a biological selection of radiosensitive head and neck cancer? Oral Oncol 2019; 94:121-122. [PMID: 31126715 DOI: 10.1016/j.oraloncology.2019.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 05/10/2019] [Accepted: 05/17/2019] [Indexed: 11/24/2022]
Affiliation(s)
- Paolo Bossi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Medical Oncology Unit, University of Brescia at ASST Spedali Civili, Brescia 25123, Italy.
| | - Emmanuel Seront
- Department of Medical Oncology, Hopital de Jolimont, 7100 Haine Saint Paul, Belgium
| | - Jean Pascal Machiels
- Institut Roi Albert II, Department of Medical Oncology, Cliniques Universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale (Pole MIRO), Université Catholique de Louvain, Brussels, Belgium
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Wiegand S, Wichmann G, Dietz A. Perspectives of Induction With Chemo and/or Immune Check Point Inhibition in Head and Neck Organ Preservation Treatment. Front Oncol 2019; 9:191. [PMID: 30972299 PMCID: PMC6443982 DOI: 10.3389/fonc.2019.00191] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 03/06/2019] [Indexed: 11/13/2022] Open
Abstract
Induction chemotherapy (ICT) is an attractive option for advanced head and neck squamous cell carcinoma (HNSCC) patients which has been prospectively evaluated in the context of a multimodality treatment approach. The theoretical benefit is the ability to suppress distant metastases and shrink the tumor while chemotherapy is better tolerated when given sequentially than concurrently. However, clinical trials have failed to show consistent benefit of ICT over concurrent radio-chemotherapy and due to so far lacking level 1 evidence ICT outside larynx organ preservation remains rather investigational. Immune modulation by inhibition of immune checkpoints is an exciting recent development in HNSCC which has mainly been investigated as second line treatment after progression on platinum-based chemotherapy in patients with recurrent/metastatic HNSCC. Due to the promising results in these trials and even more in the first-line trial KEYNOTE-048 and encouraging first preliminary results of preoperative Anti-PD1-application, the role of neoadjuvant immunotherapy is currently under investigation in HNSCC.
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Affiliation(s)
- Susanne Wiegand
- Department of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
| | - Gunnar Wichmann
- Department of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
| | - Andreas Dietz
- Department of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
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