头颈部癌症的精准肿瘤学:从分子机制到新型治疗策略

D. Sakthi Sanjana, E. Elizabeth Rani, S. Madhumitha, M. Yuvaraj, E. Karthikeyan
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摘要

颈部肿瘤包括头颈部鳞状细胞癌(HNSCC)、甲状腺癌、唾液腺肿瘤和淋巴瘤等多种恶性肿瘤。分子生物学和免疫疗法的最新进展彻底改变了这些癌症的治疗格局。以基因组剖析和生物标志物驱动疗法为指导的个性化医疗已成为改善患者预后的一种很有前景的方法。在 HNSCC 中,针对表皮生长因子受体 (EGFR) 过度表达和 PI3K/AKT/mTOR 通路的靶向疗法已显示出疗效。此外,以 PD-1/PD-L1 轴为靶点的免疫疗法已在晚期 HNSCC 中显示出持久的疗效。对于甲状腺癌,BRAF V600E 和 RET/PTC 重排已被确定为潜在的治疗靶点,BRAF 和 RET 抑制剂显示出良好的疗效。在唾液腺肿瘤中,雄激素受体信号转导和 HER2 表达已成为个性化治疗的潜在靶点。颈部淋巴瘤已从抗 CD20 单克隆抗体和布鲁顿酪氨酸激酶抑制剂的使用中获益。免疫疗法,尤其是PD-1/PD-L1阻断疗法和收养细胞疗法,在各种颈部肿瘤中都取得了令人鼓舞的疗效。同期化放疗和化疗联合靶向治疗等联合疗法进一步提高了疗效。然而,在确定预测治疗反应和克服癌症疗法耐药性的可靠生物标志物方面仍存在挑战。正在进行的临床试验和研究工作对于完善个性化治疗策略和改善颈部肿瘤患者的预后至关重要。
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Precision oncology in head and neck cancers: From molecular mechanisms to novel therapeutic strategies
Neck neoplasms encompass a diverse group of malignancies, including head and neck squamous cell carcinoma (HNSCC), thyroid cancer, salivary gland tumors, and lymphomas. Recent advancements in molecular biology and immunotherapy have revolutionized the treatment landscape for these cancers. Personalized medicine, guided by genomic profiling and biomarker-driven therapies, has emerged as a promising approach to improve patient outcomes. In HNSCC, targeted therapies focusing on epidermal growth factor receptor (EGFR) overexpression and the PI3K/AKT/mTOR pathway have shown efficacy. Additionally, immunotherapies targeting the PD-1/PD-L1 axis have demonstrated durable responses in advanced HNSCC. For thyroid cancer, BRAF V600E and RET/PTC rearrangements have been identified as potential therapeutic targets, with BRAF and RET inhibitors showing promising results. In salivary gland tumors, androgen receptor signaling and HER2 expression have emerged as potential targets for personalized treatment. Lymphomas of the neck have benefited from the use of anti-CD20 monoclonal antibodies and Bruton's tyrosine kinase inhibitors. Immunotherapy, particularly PD-1/PD-L1 blockade and adoptive cell therapy, has shown encouraging outcomes across various neck neoplasms. Combination therapies, such as concurrent chemoradiotherapy and targeted therapy with chemotherapy, have further improved treatment efficacy. However, challenges remain in identifying reliable biomarkers for predicting treatment response and overcoming resistance to cancer therapies. Ongoing clinical trials and research efforts are crucial for refining personalized treatment strategies and improving patient outcomes in neck neoplasms.
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