目前的进展和免疫治疗的未来方向在头部和部状细胞癌:一个叙事审查
Edward S Sim1,2,3, Hoang C B Nguyen1,2,3, Glenn J Hanna3
1Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts.
JAMA otolaryngology-- head & neck surgery
|March 6, 2025
概括
免疫疗法,包括免疫检查点抑制剂 (ICI),是头部和部状细胞癌 (HNSCC) 治疗的新支柱. 目前正在进行的试验探索顺序和组合方法,以改善患者生存结果.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 头部和部癌症研究研究
背景情况:
- 头部和部状细胞癌 (HNSCC) 治疗传统上依赖于手术,放射和化疗.
- 免疫疗法,特别是免疫检查点抑制剂 (ICI),已成为第四个支柱,改善复发性或转移性 (R / M) HNSCC的生存率.
- 在R/M HNSCC中ICI的初步成功是有限的,只有15-20%的患者获得了持久的反应.
研究的目的:
- 审查研究HNSCC免疫治疗的关键临床试验.
- 突出新的治疗方法和正在进行的旨在改变护理标准的研究.
- 讨论ICI在不同治疗环境中的不断变化的作用.
主要方法:
- 在HNSCC免疫疗法中完成和正在进行的临床试验的叙述性综述.
- 在复发性/转移性,最终性,新辅助性和辅助性环境中对试验结果的分析.
- 检查涉及ICI和标准疗法的组合策略.
主要成果:
- 在R/M HNSCC中,ICI已经显示出有希望的结果,但具有有限的持久反应.
- 同时使用ICI和化学辐射产生了令人失望的结果.
- 连续ICI管理 (新辅助剂,辅助剂) 显示混合但有希望的早期信号,特别是在新辅助剂试验中.
结论:
- ICI代表了HNSCC治疗模式的重大转变.
- 在某些情况下的失败需要进一步研究免疫反应的生物机制.
- 聚焦组合和顺序方法的未来研究对于扩大免疫治疗在HNSCC中的疗效至关重要.
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