Treatment strategy after the discontinuation of immunotherapy for head and neck cancer: a review  

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作  者:Tetsuro Wakasugi 

机构地区:[1]Department of Otorhinolaryngology-Head and Neck Surgery,University of Occupational and Environmental Health Japan,Fukuoka 807-8555,Japan

出  处:《Journal of Cancer Metastasis and Treatment》2023年第1期210-220,共11页癌症转移与治疗(英文版)

摘  要:First-line systemic therapy with immune checkpoint inhibitors(ICIs)is currently the mainstream treatment for recurrent or metastatic squamous cell carcinoma of the head and neck(R/M SCCHN)that is not amenable to local therapy.However,the optimal treatment after discontinuation of ICIs is still unknown,and no large-scale analysis has been conducted in R/M SCCHN.In this narrative review,we summarize the treatment strategies available to continue ICI therapy using the currently available treatment modalities.After the administration of ICIs,unlike cytotoxic agents,the following responses are observed:durable response,pseudo-progressive disease,hyper-progressive disease,mixed response,immune-related adverse events(irAEs),and improved sensitivity to subsequent chemotherapy.Some patients show a durable response to ICIs and a good prognosis;however,many patients will require salvage therapy.We need to select the subsequent treatment according to the various responses unique to ICIs to obtain a durable response.For instance,there are reports on the effectiveness of reapplication of local therapy for a mixed response,retreatment with ICIs,and off-treatment in responsive cases complicated by irAEs.If a durable response can be maintained with ICI therapy,a long-term prognosis that cannot be obtained with conventional chemotherapy can be achieved.

关 键 词:Immune checkpoint inhibitors squamous cell carcinoma head and neck 

分 类 号:R730.51[医药卫生—肿瘤]

 

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