局部晚期头颈部鳞癌的靶向治疗进展  

The progress of targeted therapy in locally advanced head and neck squamous cell carcinomas

作　　者：郭晔[1] 

机构地区：[1]复旦大学附属肿瘤医院肿瘤内科,复旦大学上海医学院肿瘤学系,上海200032

出　　处：《中国癌症杂志》2013年第12期949-953,共5页China Oncology

摘　　要：多学科联合治疗是局部晚期头颈部鳞癌的最佳治疗模式,而分子靶向药物也在近年应用到这一领域。由于头颈部鳞癌具有普遍的表皮生长因子受体(epithelial growth factor receptor,EGFR)的高表达,目前的靶向治疗主要针对这一靶点。西妥昔单抗作为一个人鼠嵌合的单克隆抗体,是目前唯一批准用于头颈部鳞癌的分子靶向药物。与单纯放疗相比,放疗联合西妥昔单抗能够显著改善局部晚期头颈部鳞癌患者的无进展生存和总生存,但与传统同期放化疗的比较无论在疗效还是不良反应方面尚不充分。随着诱导化疗在局部晚期头颈部鳞癌的研究进展,放疗联合西妥昔单抗为后续的治疗模式提供了新的研究思路。虽然RTOG 0522研究初步证明了在同期放化疗基础上再联合西妥昔单抗无法进一步提高疗效,但对于西妥昔单抗的化疗药物配伍的问题仍然值得探讨。而对于其他抗EGFR抑制剂而言,如何在现有证据基础上设计有针对性的临床研究是能否取得治疗更新的关键。Multi-disciplinary modality treatment is the optimal therapeutic strategy for locally advanced squamous cell carcinoma of head and neck （SCCHN）, Recently, molecular targeted agents have been tested in this setting. Epithelial growth factor receptor （EGFR） is the major therapeutic target because of its universally high expression in SCCHN. As a human-mouse chimeric monoclonal antibody, cetuximab is the only molecular targeted agent approved in SCCHN. As compared with radiotherapy alone, radiotherapy in combination with cetuximab was proved to improve progression-free and overall survival in patients with locally advanced SCCHN. However, randomized comparison between radiotherapy plus cetuximab and conventional concurrent chemoradiotherapy （CCRT） is limited in term of efficacy and toxicity. Although cetuximab with CCRT, the optimal chemotherapy agent RTOG 0522 study demonstrated it is ineffective to combine partner with cetuximab warrants further investigation. For otheranti-EGFR inhibitors, how to wisely design pertinent clinical studies based on available evidence is the key for success.

关 键 词：局部晚期头颈部鳞癌 靶向治疗 西妥昔单抗 同期放化疗 

分 类 号：R739.91[医药卫生—肿瘤]