Thiago Bueno de Oliveira1, Gustavo Nader Marta2, Gilberto de Castro Junior3, Luiz Paulo Kowalski4. 1. Medical Oncology Department, AC Camargo Cancer Center, Latin American Cooperative Oncology Group (LACOG), Rua Professor Antonio Prudente 211 - Bairro Liberdade, São Paulo, SP, CEP 01509-001, Brazil. thiago.oliveira@accamargo.org.br. 2. Department of Radiation Oncology, Hospital Sírio-Libanês, Latin American Cooperative Oncology Group (LACOG), São Paulo, Brazil. 3. Medical Oncology, Instituto Do Cancer Do Estado de Sao Paulo - Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo; Centro de Oncologia - Hospital Sirio Libanes, Latin American Cooperative Oncology Group (LACOG), Sao Paulo, SP, Brazil. 4. Department of Head and Neck Surgery, University of Sao Paulo Medical School. Head and Neck Surgery and Otorhinolaryngology Department, A C Camargo Cancer Center, Latin American Cooperative Oncology Group, São Paulo, Brazil.
Abstract
PURPOSE OF REVIEW: Head and neck cancer is a heterogeneous disease, comprising multiple subsites with diverse etiologic factors, pathology and molecular features, response to treatment, and prognosis. Systemic treatment is usually incorporated in the management of locally advanced head and neck squamous cell carcinoma, and the use of induction chemotherapy has theoretical benefits on reducing the risk of distant metastasis, provide an in vivo testing of response and tumor biology and the potential to allow a more personalized and less toxic local treatment after downstaging. The aim of this review is to access the role of induction chemotherapy in patients with locally advanced oral cavity cancer. RECENT FINDINGS: Clinical trials analyzing this treatment strategy in patients with resectable disease, followed by surgery, and in unresectable disease, followed by (chemo)radiotherapy or surgery are discussed, pointing out strengths and limitations of this data and highlighting the standard treatment in each clinical scenario. Future perspectives, including the incorporation of checkpoint inhibitors and biomarkers for patient selection are discussed. Surgery followed by (chemo)radiation is the standard of care for resectable oral cavity cancer patients, and chemoradiation is the standard for those considered as unresectable. Future trials with the incorporation of immunotherapy and better patient selection based on clinical and molecular biomarkers can bring new hopes for better therapeutic results in these patients.
PURPOSE OF REVIEW: Head and neck cancer is a heterogeneous disease, comprising multiple subsites with diverse etiologic factors, pathology and molecular features, response to treatment, and prognosis. Systemic treatment is usually incorporated in the management of locally advanced head and neck squamous cell carcinoma, and the use of induction chemotherapy has theoretical benefits on reducing the risk of distant metastasis, provide an in vivo testing of response and tumor biology and the potential to allow a more personalized and less toxic local treatment after downstaging. The aim of this review is to access the role of induction chemotherapy in patients with locally advanced oral cavity cancer. RECENT FINDINGS: Clinical trials analyzing this treatment strategy in patients with resectable disease, followed by surgery, and in unresectable disease, followed by (chemo)radiotherapy or surgery are discussed, pointing out strengths and limitations of this data and highlighting the standard treatment in each clinical scenario. Future perspectives, including the incorporation of checkpoint inhibitors and biomarkers for patient selection are discussed. Surgery followed by (chemo)radiation is the standard of care for resectable oral cavity cancer patients, and chemoradiation is the standard for those considered as unresectable. Future trials with the incorporation of immunotherapy and better patient selection based on clinical and molecular biomarkers can bring new hopes for better therapeutic results in these patients.
Authors: Gustavo N Marta; Rachel Riera; Paolo Bossi; Lai-ping Zhong; Lisa Licitra; Cristiane R Macedo; Gilberto de Castro Junior; André L Carvalho; William N William; Luis Paulo Kowalski Journal: Eur J Cancer Date: 2015-08-26 Impact factor: 9.162
Authors: N Gopalakrishna Iyer; Daniel S W Tan; Veronique K M Tan; Weining Wang; Jacqueline Hwang; Ngian-Chye Tan; Ranjiv Sivanandan; Hiang-Khoon Tan; Wan Teck Lim; Mei-Kim Ang; Joseph Wee; Khee-Chee Soo; Eng Huat Tan Journal: Cancer Date: 2015-01-29 Impact factor: 6.860
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Authors: Jochen H Lorch; Olga Goloubeva; Robert I Haddad; Kevin Cullen; Nicholas Sarlis; Roy Tishler; Ming Tan; John Fasciano; Daniel E Sammartino; Marshall R Posner Journal: Lancet Oncol Date: 2011-01-11 Impact factor: 41.316
Authors: Jan B Vermorken; Eva Remenar; Carla van Herpen; Thierry Gorlia; Ricard Mesia; Marian Degardin; John S Stewart; Svetislav Jelic; Jan Betka; Joachim H Preiss; Danielle van den Weyngaert; Ahmad Awada; Didier Cupissol; Heinz R Kienzer; Augustin Rey; Isabelle Desaunois; Jacques Bernier; Jean-Louis Lefebvre Journal: N Engl J Med Date: 2007-10-25 Impact factor: 91.245
Authors: Marshall R Posner; Diane M Hershock; Cesar R Blajman; Elizabeth Mickiewicz; Eric Winquist; Vera Gorbounova; Sergei Tjulandin; Dong M Shin; Kevin Cullen; Thomas J Ervin; Barbara A Murphy; Luis E Raez; Roger B Cohen; Monica Spaulding; Roy B Tishler; Berta Roth; Rosana del Carmen Viroglio; Varagur Venkatesan; Ilya Romanov; Sanjiv Agarwala; K William Harter; Matthew Dugan; Anthony Cmelak; Arnold M Markoe; Paul W Read; Lynn Steinbrenner; A Dimitrios Colevas; Charles M Norris; Robert I Haddad Journal: N Engl J Med Date: 2007-10-25 Impact factor: 91.245