内容紹介
Summary
Recent breakthrough in cancer immunotherapy employing immune checkpoint inhibitors(ICI)has evolved into number of clinical trials with antibodies against PD-1, PD-L1, and CTLA-4 for patients with squamous cell carcinoma of head and neck(SCCHN). The development of ICI in SCCHN initiated in the recurrent and metastatic setting. CheckMate141 supports nivolumab as a standard therapy for patients with platinum-refractory recurrent and metastatic-SCCHN. KEYNOTE-048 testing pembrolizumab demonstrated future practice-changing data in platinum sensitive recurrent and metastatic-SCCHN. ICI may open the door to a new era of tailor-made medicine in treatment of recurrent and metastatic-SCCHN, based on tumor burden, clinical stability, and PD-L1 status. Furthermore, ICI in combination with concurrent cisplatin based chemoradiotherapy has been investigated for locoregionally advanced disease.
要旨
近年,頭頸部癌においてprogrammed death 1(PD-1)/programmed death ligand-1(PD-L1)やcytotoxic T-lymphocyte associated antigen 4(CTLA-4)を標的とした免疫チェックポイント阻害剤(immune checkpoint inhibitors: ICI)の開発が盛んである。頭頸部扁平上皮癌(squamous cell carcinoma of head and neck: SCCHN)におけるICIの開発は,他の固形腫瘍と同様,再発・転移例を対象に口火を切り,近い将来標準治療が変わる可能性のあるエビデンスも創出されている。また,ICIを放射線治療と併用する臨床試験も数多く進行中である。本稿では頭頸部癌におけるICI開発状況について述べ,臨床的安定性や腫瘍量,PD-L1発現量に基づいた免疫療法と化学療法との使い分けの可能性など新たな個別化治療の展望についても考察したい。
目次
Recent breakthrough in cancer immunotherapy employing immune checkpoint inhibitors(ICI)has evolved into number of clinical trials with antibodies against PD-1, PD-L1, and CTLA-4 for patients with squamous cell carcinoma of head and neck(SCCHN). The development of ICI in SCCHN initiated in the recurrent and metastatic setting. CheckMate141 supports nivolumab as a standard therapy for patients with platinum-refractory recurrent and metastatic-SCCHN. KEYNOTE-048 testing pembrolizumab demonstrated future practice-changing data in platinum sensitive recurrent and metastatic-SCCHN. ICI may open the door to a new era of tailor-made medicine in treatment of recurrent and metastatic-SCCHN, based on tumor burden, clinical stability, and PD-L1 status. Furthermore, ICI in combination with concurrent cisplatin based chemoradiotherapy has been investigated for locoregionally advanced disease.
要旨
近年,頭頸部癌においてprogrammed death 1(PD-1)/programmed death ligand-1(PD-L1)やcytotoxic T-lymphocyte associated antigen 4(CTLA-4)を標的とした免疫チェックポイント阻害剤(immune checkpoint inhibitors: ICI)の開発が盛んである。頭頸部扁平上皮癌(squamous cell carcinoma of head and neck: SCCHN)におけるICIの開発は,他の固形腫瘍と同様,再発・転移例を対象に口火を切り,近い将来標準治療が変わる可能性のあるエビデンスも創出されている。また,ICIを放射線治療と併用する臨床試験も数多く進行中である。本稿では頭頸部癌におけるICI開発状況について述べ,臨床的安定性や腫瘍量,PD-L1発現量に基づいた免疫療法と化学療法との使い分けの可能性など新たな個別化治療の展望についても考察したい。