Recurrent and Metastatic Head and Neck Cancer: A Paradigm Shift?
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S2184-06282020000300263 |
Resumo: | Abstract Head and neck squamous cell carcinoma (HNSCC), the most prevalent pathological subtype of head and neck carcinoma (HNC), can be potentially cured if diagnosed at early stages and adequately treated. Still, most patients are diagnosed at stages III or IV disease, with estimated local and distant failure rates of 60% and 30%, respectively, notwithstanding aggressive multimodality curative intent treatment strategies approved. The excellent results of the EXTREME trial published in 2008 showing a median overall survival (mOS), of 10.1 months for patients with recurrent and/or metastatic (R/M) HNSCC, treated with platinum plus fluorouracil (5FU) and cetuximab, changed the standard of care (SOC), for these patients. The EXTREME regime was the first to evidence an overall survival (OS) benefit before the immunotherapy era, in this context. Two immunotherapy drugs are currently approved for treatment of R/M HNSCC in first or subsequent lines of treatment both for platinum-resistant and platinum sensitive disease: the anti-PD-1 agents nivolumab and pembrolizumab. But does this mean that there is no longer a place for the EXTREME regimen or for chemotherapy in general in R/M HNSCC treatment? And if there is, how to choose between available therapeutic options? In this article, the authors will address these questions by analyzing data from the main trials that investigated nivolumab and pembrolizumab in this setting. |
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Recurrent and Metastatic Head and Neck Cancer: A Paradigm Shift?Head and Neck Neoplasms/tratamento farmacológicoNeoplasm Recurrence, LocalNivolumabPembrolizumabAbstract Head and neck squamous cell carcinoma (HNSCC), the most prevalent pathological subtype of head and neck carcinoma (HNC), can be potentially cured if diagnosed at early stages and adequately treated. Still, most patients are diagnosed at stages III or IV disease, with estimated local and distant failure rates of 60% and 30%, respectively, notwithstanding aggressive multimodality curative intent treatment strategies approved. The excellent results of the EXTREME trial published in 2008 showing a median overall survival (mOS), of 10.1 months for patients with recurrent and/or metastatic (R/M) HNSCC, treated with platinum plus fluorouracil (5FU) and cetuximab, changed the standard of care (SOC), for these patients. The EXTREME regime was the first to evidence an overall survival (OS) benefit before the immunotherapy era, in this context. Two immunotherapy drugs are currently approved for treatment of R/M HNSCC in first or subsequent lines of treatment both for platinum-resistant and platinum sensitive disease: the anti-PD-1 agents nivolumab and pembrolizumab. But does this mean that there is no longer a place for the EXTREME regimen or for chemotherapy in general in R/M HNSCC treatment? And if there is, how to choose between available therapeutic options? In this article, the authors will address these questions by analyzing data from the main trials that investigated nivolumab and pembrolizumab in this setting.Círculo Médico2020-09-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2184-06282020000300263Gazeta Médica v.7 n.3 2020reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2184-06282020000300263Ribeiro,Leonor AbreuMelo-Alvim,CecíliaPais,Helena LunaCosta,Luísinfo:eu-repo/semantics/openAccess2024-02-06T17:32:09Zoai:scielo:S2184-06282020000300263Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:35:01.183736Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Recurrent and Metastatic Head and Neck Cancer: A Paradigm Shift? |
title |
Recurrent and Metastatic Head and Neck Cancer: A Paradigm Shift? |
spellingShingle |
Recurrent and Metastatic Head and Neck Cancer: A Paradigm Shift? Ribeiro,Leonor Abreu Head and Neck Neoplasms/tratamento farmacológico Neoplasm Recurrence, Local Nivolumab Pembrolizumab |
title_short |
Recurrent and Metastatic Head and Neck Cancer: A Paradigm Shift? |
title_full |
Recurrent and Metastatic Head and Neck Cancer: A Paradigm Shift? |
title_fullStr |
Recurrent and Metastatic Head and Neck Cancer: A Paradigm Shift? |
title_full_unstemmed |
Recurrent and Metastatic Head and Neck Cancer: A Paradigm Shift? |
title_sort |
Recurrent and Metastatic Head and Neck Cancer: A Paradigm Shift? |
author |
Ribeiro,Leonor Abreu |
author_facet |
Ribeiro,Leonor Abreu Melo-Alvim,Cecília Pais,Helena Luna Costa,Luís |
author_role |
author |
author2 |
Melo-Alvim,Cecília Pais,Helena Luna Costa,Luís |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Ribeiro,Leonor Abreu Melo-Alvim,Cecília Pais,Helena Luna Costa,Luís |
dc.subject.por.fl_str_mv |
Head and Neck Neoplasms/tratamento farmacológico Neoplasm Recurrence, Local Nivolumab Pembrolizumab |
topic |
Head and Neck Neoplasms/tratamento farmacológico Neoplasm Recurrence, Local Nivolumab Pembrolizumab |
description |
Abstract Head and neck squamous cell carcinoma (HNSCC), the most prevalent pathological subtype of head and neck carcinoma (HNC), can be potentially cured if diagnosed at early stages and adequately treated. Still, most patients are diagnosed at stages III or IV disease, with estimated local and distant failure rates of 60% and 30%, respectively, notwithstanding aggressive multimodality curative intent treatment strategies approved. The excellent results of the EXTREME trial published in 2008 showing a median overall survival (mOS), of 10.1 months for patients with recurrent and/or metastatic (R/M) HNSCC, treated with platinum plus fluorouracil (5FU) and cetuximab, changed the standard of care (SOC), for these patients. The EXTREME regime was the first to evidence an overall survival (OS) benefit before the immunotherapy era, in this context. Two immunotherapy drugs are currently approved for treatment of R/M HNSCC in first or subsequent lines of treatment both for platinum-resistant and platinum sensitive disease: the anti-PD-1 agents nivolumab and pembrolizumab. But does this mean that there is no longer a place for the EXTREME regimen or for chemotherapy in general in R/M HNSCC treatment? And if there is, how to choose between available therapeutic options? In this article, the authors will address these questions by analyzing data from the main trials that investigated nivolumab and pembrolizumab in this setting. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-09-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S2184-06282020000300263 |
url |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S2184-06282020000300263 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S2184-06282020000300263 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Círculo Médico |
publisher.none.fl_str_mv |
Círculo Médico |
dc.source.none.fl_str_mv |
Gazeta Médica v.7 n.3 2020 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
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1799137404974530560 |