帕博利珠单抗联合二甲双胍治疗转移性头颈部癌的 II 期可行性研究
A Phase II Feasibility Study Combining Pembrolizumab and Metformin in Patients with Metastatic Head and Neck Cancer.
二甲双胍联合帕博利珠单抗耐受性良好,仅出现轻度胃肠道不良事件,并展现出有前景的活性,值得在随机试验中进一步研究。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Head and neck squamous cell carcinoma: current and emerging therapeutic strategies.
Head and neck squamous cell carcinoma: current and emerging therapeutic strategies.
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头颈部鳞状细胞癌(HNSCC)是一种复杂、侵袭性强且具有异质性的恶性肿瘤,全球发病率呈快速上升趋势。烟草使用、饮酒和人乳头瘤病毒(HPV)感染是HNSCC的主要相关危险因素。放疗、化疗和手术切除等标准治疗常伴有严重副作用且疗效有限,在晚期、复发或转移性疾病中尤为明显。尽管免疫检查点抑制剂的引入改变了复发或转移性疾病的治疗格局,但由于多数患者未能达到预期预后,且肿瘤微环境呈“冷”状态,其临床影响仍有限。因此,开发更有效、耐受性更好的靶向药物是改善HNSCC患者临床结局的优先事项。本综述介绍现有治疗策略及传统疗法面临的挑战,并讨论先进手术、免疫治疗、表观遗传学和癌症干细胞靶向等前沿治疗方式。此外,在多项临床前和临床研究中,将上述传统方法与先进疗法进行不同的复杂组合,已取得更好的HNSCC预后。持续开展针对分子通路和创新药物递送系统的多学科研究,有望显著提高疗效,同时维持患者生活质量。
Head and neck squamous cell carcinoma (HNSCC) is a complex, aggressive and heterogeneous malignancy with trends rising rapidly worldwide. Tobacco use, alcohol consumption and human papillomavirus (HPV) infection are the leading risk factors associated with the occurrence of HNSCC.
Standard treatments, including radiotherapy, chemotherapy, and surgical resection, are often associated with severe side effects and limited success, particularly in advanced, recurrent, or metastatic disease. Though the introduction of immune checkpoint inhibitors has reshaped the management of recurrent or metastatic disease, the clinical impact remains limited as a majority of patients do not achieve expected prognosis, attributed to a "cold" tumor microenvironment.
Therefore, to enhance the clinical outcomes of HNSCC patients, it is priority to investigate more effective and well-tolerated targeted medicines. This review provides insights about the current treatment strategies, challenges associated with these traditional approaches along with shedding light on the state-of-the-art HNSCC treatment modalities such as advanced surgery, immunotherapy, epigenetics and cancer stem cell targeting, etc.
Moreover, therapies involving varied sophisticated combinations of the abovementioned conventional approaches and these advanced treatment modalities have yielded better HNSCC prognosis in multiple preclinical and clinical settings. Continued multidisciplinary research targeting molecular pathways and innovative drug delivery systems hold the potential to remarkably enhance treatment efficacy while preserving patient's quality of life.
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