Cancers of the head & neck最新文献

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ECOG-ACRIN 2399: analysis of patient related outcomes after Chemoradiation for locally advanced head and neck Cancer. ECOG-ACRIN 2399:局部晚期头颈癌放化疗后患者相关结局分析
Cancers of the head & neck Pub Date : 2020-12-22 DOI: 10.1186/s41199-020-00059-1
Anthony Cmelak, Mary S Dietrich, Shuli Li, Sheila Ridner, Arlene Forastiere, Barbara A Burtness, David Cella, Barbara A Murphy
{"title":"ECOG-ACRIN 2399: analysis of patient related outcomes after Chemoradiation for locally advanced head and neck Cancer.","authors":"Anthony Cmelak,&nbsp;Mary S Dietrich,&nbsp;Shuli Li,&nbsp;Sheila Ridner,&nbsp;Arlene Forastiere,&nbsp;Barbara A Burtness,&nbsp;David Cella,&nbsp;Barbara A Murphy","doi":"10.1186/s41199-020-00059-1","DOIUrl":"https://doi.org/10.1186/s41199-020-00059-1","url":null,"abstract":"<p><strong>Background: </strong>We conducted a correlative study for E2399, a function preservation trial for resectable locally advanced oropharynx and larynx cancer, to prospectively assess effects of chemoradiation (CCR) on quality of life (QOL), swallowing and voice. We correlated the results of swallow assessments done via questionnaires and objective assessments by modified barium swallow (MBS).</p><p><strong>Methods: </strong>The Functional Assessment of Cancer-HN (FACT-HN), the Performance Status Scale - Head and Neck (PSS-HN), swallow assessments (including modified barium swallow studies), and voice assessments: Voice Handicap Index (VHI), the Voice Disability Assessment (VDA), and American Speech-Language Hearing Association's Functional Communication Measure (FCM) were conducted at baseline and periodically post-treatment for 2 years.</p><p><strong>Results: </strong>Baseline QOL and swallowing function predicted overall survival. Patients experienced a marked decrease in QOL, swallowing, and speech post CCR although the decrease in vocal function was modest. Function and QOL returned towards baseline in the majority of patients by 12 months post treatment. Less than 10% of patients had severe dysphagia and were PEG dependent at 12 months post treatment. There was a high degree of correlation between the FACT-HN and PSS-HN swallow items. Statistically significant correlations were found between subjective and objective measures of swallow function.</p><p><strong>Conclusions: </strong>Patients experience marked loss in swallowing function post CCR which returned to baseline in the majority of patients. The correlations between the FCM and self-report swallow items on the PSS and FACT-HN appear to be sufficiently strong to justify their use as a surrogate marker for swallowing disability in large therapeutic trials.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41199-020-00059-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38743845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Determining the molecular landscape and impact on prognosis in HPV-associated head and neck cancer. 确定人乳头瘤病毒相关头颈癌的分子结构及其对预后的影响。
Cancers of the head & neck Pub Date : 2020-09-09 eCollection Date: 2020-01-01 DOI: 10.1186/s41199-020-00058-2
Suchin Khanna, Sarah Palackdharry, Logan Roof, Christina A Wicker, Jonathan Mark, Zheng Zhu, Roman Jandorav, Alfredo Molinolo, Vinita Takiar, Trisha M Wise-Draper
{"title":"Determining the molecular landscape and impact on prognosis in HPV-associated head and neck cancer.","authors":"Suchin Khanna, Sarah Palackdharry, Logan Roof, Christina A Wicker, Jonathan Mark, Zheng Zhu, Roman Jandorav, Alfredo Molinolo, Vinita Takiar, Trisha M Wise-Draper","doi":"10.1186/s41199-020-00058-2","DOIUrl":"10.1186/s41199-020-00058-2","url":null,"abstract":"<p><strong>Background: </strong>Human papillomavirus (HPV) associated head and neck squamous cell carcinoma (HNSCC) has a better prognosis than HNSCC due to other risk factors. However, there is significant heterogeneity within HPV-associated HNSCC and 25% of these patients still do poorly despite receiving aggressive therapy. We currently have no good molecular tools to differentiate and exclude this \"high-risk\" sub-population and focus on \"low-risk\" patients for clinical trials. This has been a potential barrier to identifying successful de-escalation treatment strategies in HPV-associated HNSCC. We conducted an analysis of molecular markers with a well-known role in the pathogenesis of HPV-associated HNSCC and hypothesized that these markers could help independently predict recurrence and prognosis in these patients and therefore help identify at the molecular level \"low-risk\" patients suitable for de-escalation trials.</p><p><strong>Methods: </strong>We analyzed 24 tumor specimens of patients with p16+ HNSCC who underwent definitive resection as primary treatment. Tissue microarray (TMA) was generated from the 24 pathology blocks and immunohistochemistry (IHC) was performed using highly specific antibodies for our chosen biomarkers (PI3K-PTEN, AKT pathway, mTOR, 4EBP1, S6, and pAMPK, ERCC-1). Transcriptome data was also obtained for 7 p16+ HNSCC patients from The Cancer Genome Atlas (TCGA). Data from the TMA and TCGA were analyzed for association of relapse-free survival (RFS) and overall survival (OS) with protein and gene expression of the chosen biomarkers.</p><p><strong>Results: </strong>Increased pAMPK protein activity by IHC and AMPK gene expression by TCGA gene expression data was correlated with improved RFS with a trend towards statistical significance.</p><p><strong>Conclusions: </strong>This data suggests that increased pAMPK activity and expression may portend a better prognosis in HPV-associated HNSCC undergoing primary definitive resection. However, these findings require validation in larger studies.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7487583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38394504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A descriptive study of human papilloma virus in upper aero-digestive squamous cell carcinoma at Uganda cancer institute assessed by P16 immunohistochemistry. 用P16免疫组织化学评价乌干达癌症研究所上消化道鳞状细胞癌中人乳头状瘤病毒的描述性研究。
Cancers of the head & neck Pub Date : 2020-08-27 eCollection Date: 2020-01-01 DOI: 10.1186/s41199-020-00057-3
Fiona Kabagenyi, Jeff Otiti, Justine Namwagala, Adriane Kamulegeya, Sam Kalungi
{"title":"A descriptive study of human papilloma virus in upper aero-digestive squamous cell carcinoma at Uganda cancer institute assessed by P16 immunohistochemistry.","authors":"Fiona Kabagenyi, Jeff Otiti, Justine Namwagala, Adriane Kamulegeya, Sam Kalungi","doi":"10.1186/s41199-020-00057-3","DOIUrl":"10.1186/s41199-020-00057-3","url":null,"abstract":"<p><strong>Background: </strong>Cancer burden in sub-Saharan Africa is on the rise with one-third of cancers estimated to be caused by infectious agents. Head and neck squamous cell cancer (HNSCC) is the sixth most common malignancy in sub-Saharan Africa and includes tumors in the Upper Aero-digestive Tract (UADT). The established risk factors are tobacco and alcohol exposure with a recent recognition of the role of Human Papilloma Virus (HPV). The HPV related HNC is seen predominantly in the oropharynx, presents at a younger age and has a better prognosis. With a rapidly increasing incidence of these cancers in the developed world, it was important to study HPV in HNC in Uganda. The HPV can be detected using P16 immunohistochemistry as a surrogate marker thus making it suitable for screening. The study aimed at establishing the presence of HPV and the commonly affected sites in UADT squamous cell carcinoma (SCC) at Uganda Cancer Institute (UCI) using P16 immunohistochemistry.</p><p><strong>Methodology: </strong>This was a cross sectional study in which 59 patients with histologically proven SCC from the oral cavity, oropharynx, larynx and hypopharynx were recruited. These patients' demographics and clinical data were collected. Tissue sections from retrieved histology samples were stained by Haematoxylin and Eosin to reconfirm SCC. Subsequently, P16 expression was determined using P16 immunohistochemistry.</p><p><strong>Results: </strong>Seventy-one patients were enrolled and 59 patients with confirmed SCC of the sites of interest were analyzed. The majority (79.7%) of the participants were male and over 50 years. 59.3% were tobacco smokers, 66.1% used alcohol, 52.2% used both. Only 27.1% used none of the substances. Only 27.1% of the participants were HIV positive. Most of the tumors were in the larynx (37.3%) and 64.4% were overall TNM stage 4. The overall prevalence of HPV in UADT SCC at UCI was 20.3, 95%CI 10.9-32.8. The oropharynx had the highest prevalence (30.8%).</p><p><strong>Conclusion: </strong>The prevalence of HPV in UADT SCC at UCI is significant at 20.3%. The most affected site, is the oropharynx. Vigilant HPV screening of these sites with confirmation where possible is recommended.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41199-020-00057-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38325601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Preclinical models of head and neck squamous cell carcinoma for a basic understanding of cancer biology and its translation into efficient therapies. 头颈部鳞状细胞癌的临床前模型,为癌症生物学的基本认识及其转化为有效的治疗。
Cancers of the head & neck Pub Date : 2020-07-23 eCollection Date: 2020-01-01 DOI: 10.1186/s41199-020-00056-4
Ingeborg Tinhofer, Diana Braunholz, Konrad Klinghammer
{"title":"Preclinical models of head and neck squamous cell carcinoma for a basic understanding of cancer biology and its translation into efficient therapies.","authors":"Ingeborg Tinhofer,&nbsp;Diana Braunholz,&nbsp;Konrad Klinghammer","doi":"10.1186/s41199-020-00056-4","DOIUrl":"https://doi.org/10.1186/s41199-020-00056-4","url":null,"abstract":"<p><p>Comprehensive molecular characterization of head and neck squamous cell carcinoma (HNSCC) has led to the identification of distinct molecular subgroups with fundamental differences in biological properties and clinical behavior. Despite improvements in tumor classification and increased understanding about the signaling pathways involved in neoplastic transformation and disease progression, current standard-of-care treatment for HNSCC mostly remains to be based on a stage-dependent strategy whereby all patients at the same stage receive the same treatment. Preclinical models that closely resemble molecular HNSCC subgroups that can be exploited for dissecting the biological function of genetic variants and/or altered gene expression will be highly valuable for translating molecular findings into improved clinical care. In the present review, we merge and discuss existing and new information on established cell lines, primary two- and three-dimensional ex vivo tumor cultures from HNSCC patients, and animal models. We review their value in elucidating the basic biology of HNSCC, molecular mechanisms of treatment resistance and their potential for the development of novel molecularly stratified treatment.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41199-020-00056-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38194738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 19
Improvement of a delayed swallowing reflex following treatment for advanced head and neck cancer. 晚期头颈癌治疗后延迟吞咽反射的改善。
Cancers of the head & neck Pub Date : 2020-06-02 eCollection Date: 2020-01-01 DOI: 10.1186/s41199-020-00055-5
Akira Ohkoshi, Kengo Kato, Takenori Ogawa, Ayako Nakanome, Ryo Ishii, Yukio Katori
{"title":"Improvement of a delayed swallowing reflex following treatment for advanced head and neck cancer.","authors":"Akira Ohkoshi,&nbsp;Kengo Kato,&nbsp;Takenori Ogawa,&nbsp;Ayako Nakanome,&nbsp;Ryo Ishii,&nbsp;Yukio Katori","doi":"10.1186/s41199-020-00055-5","DOIUrl":"https://doi.org/10.1186/s41199-020-00055-5","url":null,"abstract":"<p><strong>Background: </strong>The latency of the swallowing reflex is an important factor causing dysphagia in head and neck cancer patients. Although there are many reports comparing voluntary swallowing function before and after treatment, few studies have focused on the latency of the swallowing reflex, which is a risk factor for pneumonia due to silent aspiration. The aim of this retrospective study was to clarify the changes in the latency of the swallowing reflex before and after treatment.</p><p><strong>Methods: </strong>The latency of the swallowing reflex was quantified using the time from the injection of 1 ml of distilled water into the pharynx through a nasal catheter to the onset of swallowing.</p><p><strong>Results: </strong>The latency time of the swallowing reflex was significantly decreased 3 months after treatment compared to before treatment. A significant reduction was also observed in patients with pharyngeal cancer who underwent chemoradiation therapy.</p><p><strong>Conclusions: </strong>This retrospective study showed that a delayed swallowing reflex improved with treatment in advanced head and neck cancer patients.</p><p><strong>Trial registration: </strong>The Institutional Review Board of Tohoku University Hospital (Number 2014-1-274).</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41199-020-00055-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38023343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Response of the Istituto Nazionale Tumori of Milan Head & Neck Cancer Unit to the COVID-19 outbreak. 米兰国家肿瘤研究所头颈癌科对COVID-19疫情的反应。
Cancers of the head & neck Pub Date : 2020-05-06 eCollection Date: 2020-01-01 DOI: 10.1186/s41199-020-00054-6
Carlo Resteghini, Paola Maggioni, Vito Di Martino, Lisa Licitra
{"title":"Response of the Istituto Nazionale Tumori of Milan Head & Neck Cancer Unit to the COVID-19 outbreak.","authors":"Carlo Resteghini,&nbsp;Paola Maggioni,&nbsp;Vito Di Martino,&nbsp;Lisa Licitra","doi":"10.1186/s41199-020-00054-6","DOIUrl":"https://doi.org/10.1186/s41199-020-00054-6","url":null,"abstract":"","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41199-020-00054-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37919863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Applications of radiomics in precision diagnosis, prognostication and treatment planning of head and neck squamous cell carcinomas. 放射组学在头颈部鳞状细胞癌精准诊断、预后及治疗计划中的应用。
Cancers of the head & neck Pub Date : 2020-05-04 eCollection Date: 2020-01-01 DOI: 10.1186/s41199-020-00053-7
Stefan P Haider, Barbara Burtness, Wendell G Yarbrough, Seyedmehdi Payabvash
{"title":"Applications of radiomics in precision diagnosis, prognostication and treatment planning of head and neck squamous cell carcinomas.","authors":"Stefan P Haider,&nbsp;Barbara Burtness,&nbsp;Wendell G Yarbrough,&nbsp;Seyedmehdi Payabvash","doi":"10.1186/s41199-020-00053-7","DOIUrl":"https://doi.org/10.1186/s41199-020-00053-7","url":null,"abstract":"<p><p>Recent advancements in computational power, machine learning, and artificial intelligence technology have enabled automated evaluation of medical images to generate quantitative diagnostic and prognostic biomarkers. Such objective biomarkers are readily available and have the potential to improve personalized treatment, precision medicine, and patient selection for clinical trials. In this article, we explore the merits of the most recent addition to the \"-omics\" concept for the broader field of head and neck cancer - \"Radiomics\". This review discusses radiomics studies focused on (molecular) characterization, classification, prognostication and treatment guidance for head and neck squamous cell carcinomas (HNSCC). We review the underlying hypothesis, general concept and typical workflow of radiomic analysis, and elaborate on current and future challenges to be addressed before routine clinical application.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41199-020-00053-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37921764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 44
An update on angiogenesis targeting in head and neck squamous cell carcinoma. 头颈部鳞状细胞癌血管新生靶向研究进展。
Cancers of the head & neck Pub Date : 2020-04-06 eCollection Date: 2020-01-01 DOI: 10.1186/s41199-020-00051-9
Ida Micaily, Jennifer Johnson, Athanassios Argiris
{"title":"An update on angiogenesis targeting in head and neck squamous cell carcinoma.","authors":"Ida Micaily,&nbsp;Jennifer Johnson,&nbsp;Athanassios Argiris","doi":"10.1186/s41199-020-00051-9","DOIUrl":"https://doi.org/10.1186/s41199-020-00051-9","url":null,"abstract":"<p><p>Angiogenesis is an integral aspect of the growth and proliferation of solid tumors, including head and neck squamous cell carcinoma (HNSCC), and has potential implications in prognosis and treatment of both localized and recurrent/metastatic HNSCC. Therefore, there has been a significant interest in utilizing anti-angiogenic agents either alone or in combination with currently approved and emerging therapies. A phase III randomized trial (E1305) of chemotherapy with or without bevacizumab in the first-line treatment of recurrent/metastatic HNSCC showed an increased response rate and longer progression-free survival but fell short in demonstrating a statistically significant improved survival with bevacizumab. Moreover, toxicity, especially bleeding, was increased. Nevertheless, the study of other anti-angiogenic agents and novel combinations with other therapies, including immunotherapy, remains of interest. Several clinical trials are currently underway.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41199-020-00051-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37827046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 29
The neoadjuvant paradigm reinvigorated: a review of pre-surgical immunotherapy in HNSCC. 新辅助范式的重新激活:术前免疫治疗在HNSCC的回顾。
Cancers of the head & neck Pub Date : 2020-03-16 eCollection Date: 2020-01-01 DOI: 10.1186/s41199-020-00052-8
Margaret Stafford, John Kaczmar
{"title":"The neoadjuvant paradigm reinvigorated: a review of pre-surgical immunotherapy in HNSCC.","authors":"Margaret Stafford,&nbsp;John Kaczmar","doi":"10.1186/s41199-020-00052-8","DOIUrl":"https://doi.org/10.1186/s41199-020-00052-8","url":null,"abstract":"<p><strong>Background: </strong>There remains up to a 50% recurrence rate in advanced p16- head and neck squamous cell carcinoma with current standard of care treatment. In an attempt to improve survival, multiple trials administering induction or neoadjuvant chemotherapy have been conducted but none demonstrated improved overall survival. The established efficacy of immune checkpoint inhibitors in the recurrent and metastatic setting has produced widespread interest in their neoadjuvant use.</p><p><strong>Purpose: </strong>To survey the landscape of active neoadjuvant immunotherapy trials in head and neck squamous cell carcinoma and summarize and synthesize currently available outcomes from these trials.</p><p><strong>Conclusions: </strong>Neoadjuvant immunotherapy has proven safe and well tolerated in head and neck squamous cell carcinoma with encouraging efficacy results, including relatively high rates of pathologic response. Ongoing studies offer an opportunity to study immune responses in vivo. PD-L1 positivity, high tumor mutational burden and infiltration of NK cells, CD8, CD26 and Tim3 positive lymphocytes at time of surgery have been correlated with pathologic responses. We await updated reports of disease free survival and overall survival data and results of ongoing phase III studies utilizing neoadjuvant immunotherapy to determine if this treatment paradigm will have a place in the standard of care treatment in head and neck squamous cell carcinoma.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41199-020-00052-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37756429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 28
Pembrolizumab-induced Hemophagocytic Lymphohistiocytosis: an immunotherapeutic challenge. 派姆单抗诱导的噬血细胞淋巴组织细胞增多症:一种免疫治疗挑战。
Cancers of the head & neck Pub Date : 2020-02-03 eCollection Date: 2020-01-01 DOI: 10.1186/s41199-020-0050-3
James Kalmuk, Jon Puchalla, Gong Feng, Anshu Giri, John Kaczmar
{"title":"Pembrolizumab-induced Hemophagocytic Lymphohistiocytosis: an immunotherapeutic challenge.","authors":"James Kalmuk,&nbsp;Jon Puchalla,&nbsp;Gong Feng,&nbsp;Anshu Giri,&nbsp;John Kaczmar","doi":"10.1186/s41199-020-0050-3","DOIUrl":"https://doi.org/10.1186/s41199-020-0050-3","url":null,"abstract":"<p><strong>Background: </strong>As the number of indicated malignancies for which immune checkpoint inhibitor therapy such as pembrolizumab grows the descriptions of associated immune-related adverse events (irAEs) increases as well. On rare occasions immunotherapy can lead to development of Hemophagocytic Lymphohistiocytosis (HLH) which is a potentially lethal inflammatory disorder characterized by histiocyte activation and cytokine storm. At this time no cases of HLH developing in head and neck squamous cell carcinoma (HNSCC) patients receiving pembrolizumab have been reported.</p><p><strong>Case presentation: </strong>Here we describe the first documented case of pembrolizumab-induced HLH in a 61 year-old male with metastatic HNSCC after having received multiple prior cycles of pembrolizumab without event. Following cycle 14 the patient developed fever associated with new pancytopenia and transaminitis prompting hospital admission. Infectious workup was negative, his metastatic lesions were found to be stable, and there was no evidence of new malignancy. Further workup demonstrated hyperferritinemia and bone marrow biopsy demonstrated hemophagocytosis concerning for pembrolizumab-induced HLH. Etoposide and dexamethasone therapy was initiated leading to clinical improvement and safe discharge.</p><p><strong>Conclusions: </strong>Immunotherapy is a groundbreaking therapeutic intervention for patients with malignancy, however by nature of their mechanism carry a risk of inflammatory side effects. In rare circumstances these inflammatory reactions include potentially deadly syndromes such as HLH. As immunotherapeutics such as pembrolizumab become more widely utilized increased awareness of complications such as HLH is clinically relevant.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41199-020-0050-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37615123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 20
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