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Molecular targeted therapy, advanced treatment for cancers of the head-and-neck region: A systematic review
Firdous Shaikh1, Sonia Kaur Sodhi2, Lata M Kale2
1Senior Lecture, Department of Oral Medicine and Radiology, Rural Dental College, Pravara Medical Trust-Pravara Institute of Medical Sciences, Aurangabad, Maharashtra, India.
Introduction:
The foundation of oncology treatment as a single modality approach as well as the "multimodality" concept has been studied by statistical evaluation pre, during, and posttreatment to rule out their efficacy, expected prognosis, toxicity reactions, and overall survival for the patient. Such studies have also provided an appreciable amount of data for future custom utility. "Targeted therapy" is a cancer treatment that uses drugs but is different from traditional chemotherapy. It works by targeting cancer-specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. Researchers are developing drugs that target specific molecular changes. The drugs can block or turn off signals that tell cancer cells to grow and divide, keep cells from living longer than usual, and destroy the cancer cells.
Aim:
The aim of the study is to carry out a systematic review of clinical trials of molecular targeted therapy in the treatment of cancer.
Objective:
The objective of the study is to evaluate the efficacy of molecular targeted therapy in the treatment of head-and-neck cancers.
Materials And Methods:
A group of keywords was preselected to search for scientific articles on a web-based database of PubMed. Only completed randomized controlled trials published in the past 5 years in the English language were included with open access. All the selected articles were subjected to the Cochrane bias tool and PRISMA guidelines to extract results.
Results:
Among 4 studies specifying the progression-free survival (PFS) for comparing the groups treated either using targeted therapy or other modality/placebo, 50% of studies show a slight increase in PFS in the group treated with TT and other 50% show PFS increase in the non-TT group. Thus, insufficient evidence is furnished to provide a statement and acknowledged the expectancy of a disease-free period with or without the use of TT in the treatment of head-and-neck cancer.
Conclusion:
Considering very little information on enhanced effect and presence of evidence supporting an increased risk of adverse events, the addition of TT to treatment is a question to the dilemma. A systematic review intends advantageous in providing foresight for oncologists concerning patient assessment and evaluation to defend inclination proceeding toward the treatment defined.
Insights
This systematic review found insufficient evidence to support targeted therapy for head-and-neck cancers, noting potential adverse events. Further research is needed to clarify the role of targeted therapy in improving progression-free survival.
Area of Science:
- Oncology
- Molecular Biology
- Clinical Trials
Background:
- Traditional oncology treatments and multimodality approaches are evaluated for efficacy, prognosis, toxicity, and survival.
- Targeted therapy represents a distinct approach, utilizing drugs to target cancer-specific genes, proteins, or the tumor microenvironment.
- This therapy aims to inhibit cancer cell growth, division, and survival by blocking critical molecular pathways.
Approach:
- A systematic review was conducted on clinical trials of molecular targeted therapy in cancer treatment.
- The review focused specifically on evaluating the efficacy of molecular targeted therapy in head-and-neck cancers.
- Eligible studies included completed randomized controlled trials published in English within the last five years, accessed via PubMed, and subjected to PRISMA guidelines and Cochrane bias assessment.
Key Points:
- Four studies reported progression-free survival (PFS) data comparing targeted therapy (TT) with other modalities or placebo.
- Fifty percent of the studies indicated a slight PFS increase with TT, while the other fifty percent showed an increase in the non-TT group.
- This data provides insufficient evidence to definitively state whether TT enhances disease-free periods in head-and-neck cancer treatment.
Conclusions:
- Limited information exists regarding the enhanced efficacy of targeted therapy in head-and-neck cancers.
- Evidence suggests a potential increased risk of adverse events associated with targeted therapy.
- The addition of targeted therapy presents a dilemma, necessitating careful patient assessment by oncologists to guide treatment decisions.
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