RESUMO
BACKGROUND: The number of patients suffering from human papillomavirus (HPV)-associated oropharyngeal cancer has increased in recent decades. To date, the role of medical therapy in patients with squamous cell carcinoma of the head and neck region has only been established in the refractory or metastatic setting (r/m HNSCC). OBJECTIVE: What are the current treatment options for patients with r/m HNSCC or r/m oropharyngeal cancer? MATERIALS AND METHODS: A literature search was conducted on systemic treatment of oropharyngeal cancer and r/m HNSCC. RESULTS: There is currently no standard treatment for patients with oropharyngeal cancer in refractory or metastatic stages. Since 2017, immunotherapy with checkpoint inhibitors has become increasingly important in the treatment of r/m HNSCC patients. First-line therapy was recently adapted based on the results of the KEYNOTE-48 (KN048) study. For selected patients with r/m HNSCC, there now exists a chemotherapy-free treatment option. Use of immunotherapy also in earlier stages of HNSCC can be expected in the near future. CONCLUSION: Medical therapy of r/m HNSCC patients is in a period of great change. Treatment is increasingly based on combination therapy with checkpoint inhibitors.
Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Orofaríngeas , Carcinoma de Células Escamosas/tratamento farmacológico , Humanos , Neoplasias Orofaríngeas/terapia , Papillomaviridae , Carcinoma de Células Escamosas de Cabeça e PescoçoRESUMO
Salivary duct carcinoma (SDC) is a rare and highly aggressive neoplasm of the salivary glands associated with high rates of local and distant recurrence and poor overall survival. We present a patient with SDC, who relapsed despite extensive multimodal therapy including surgery, postoperative radiochemotherapy, and heavy ion therapy. In the recurrent setting, immunohistochemical analysis confirmed androgen receptor positivity, prompting initiation of combined androgen deprivation therapy (ADT), which resulted in a fast and durable remission of the local tumor now lasting for 26 months. Analyzing the histopathologic specimens of all SDC patients treated at our department since 2009, we found significant AR expression in all patients. This is in line with other reports found in current literature and indicates AR positivity as a consistent feature of SDC, supporting ADT as a viable therapeutic option for SDC.
Assuntos
Antagonistas de Androgênios , Neoplasias da Próstata , Antagonistas de Androgênios/uso terapêutico , Humanos , Masculino , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/tratamento farmacológico , Receptores Androgênicos/genética , Ductos SalivaresRESUMO
Lung cancer occurs with a median age of 69 years. The main cause is cigarette smoking. For both genders lung cancer is the third-most frequent tumor in Germany. While in an operable tumor stage 30-80% of the patients can reach long-term survival, the prognosis in the metastasised stage is unfavourable with a 5-year overall survival rate of 6% for small cell lung cancer (SCLC) and 18% for non-small cell lung cancer (NSCLC). Lung cancer is subject of intense research to improve the outcome. This article gives an overview of current treatment options.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/terapia , Carcinoma de Células Pequenas/terapia , Neoplasias Pulmonares/terapia , Idoso , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma de Células Pequenas/mortalidade , Carcinoma de Células Pequenas/patologia , Terapia Combinada , Feminino , Alemanha , Humanos , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Cuidados Paliativos , Guias de Prática Clínica como Assunto , Prognóstico , Fumar/efeitos adversos , Taxa de SobrevidaAssuntos
Proliferação de Células , Aberrações Cromossômicas , Leucemia Linfocítica Crônica de Células B/genética , Leucemia Linfocítica Crônica de Células B/patologia , Mieloma Múltiplo/genética , Mieloma Múltiplo/patologia , Idoso , Medula Óssea/metabolismo , Medula Óssea/patologia , Humanos , Cadeias Pesadas de Imunoglobulinas/genética , Hibridização in Situ Fluorescente , Leucemia Linfocítica Crônica de Células B/terapia , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/terapia , Análise de Sequência com Séries de Oligonucleotídeos , Polimorfismo de Nucleotídeo Único/genéticaRESUMO
Non-Hodgkin s lymphoma (NHL) includes a group of malignant lymphoproliferative disorders, that particularly occur in the elderly and have an continuously increasing incidence. Because of the age distribution new treatment options with low toxicity and minor side effects - apart from "conventional" therapies like standard or high dose chemotherapy - are needed. Within these novel therapeutic modalities the use of the monoclonal antibody rituximab has been widely established. Other monoclonal antibodies, such as the anti-CD52-antibody alemtuzumab, are available for the treatment of chronic lymphatic leukemia (CLL) and T-cell-lymphomas and are being tested in clinical trials. Furthermore the option of combining targeted therapies, in which antibodies are used with radiotherapy, has led to the development of radio-immunotherapies that are now becoming available for clinical use. Current results in the treatment of advanced indolent lymphomas are promising, and their use in high-grade lymphoma and as first-line therapy is under investigation. This article summarizes the application of these novel immunotherapies and reviews the results of recent clinical trials, with particular emphasis on indications and practical aspects in everyday clinical life.
