Alpelisib 和免疫疗法：治疗复发性和转移性头颈部鳞状细胞癌的前景看好的组合疗法。

IF 1.5 Q4 ONCOLOGY

Cancer reports Pub Date : 2024-10-07 DOI:10.1002/cnr2.70023

Riham Suleiman, Patrick McGarrah, Binav Baral, Dawn Owen, Jesus Vera Aguilera, Thor R. Halfdanarson, Katharine A. Price, Harry E. Fuentes Bayne

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引用次数: 0

摘要

背景：头颈部复发性鳞状细胞癌（SCC）尽管有可用的治疗方法，但仍是一项艰巨的临床挑战。磷脂酰肌醇3-激酶（PI3K）通路已被确定为潜在的治疗靶点，选择性PI3Kα抑制剂alpelisib已在某些恶性肿瘤中显示出疗效。以往的研究表明，将这种靶向疗法与免疫疗法相结合是一种很有前景的增强抗癌免疫反应的策略：一名 69 岁女性，左侧上颌骨 PIK3CA 突变 SCC 局部复发，并伴有颈部结节转移。包括顺铂、多西他赛、5FU、化放疗和单一免疫疗法在内的多种化疗方案均导致疾病进展。Alpelisib 联合 pembrolizumab 治疗后，患者获得了长达 9 个月的持续应答。一名 58 岁男性，口咽部复发性转移性 PIK3CA 突变 SCC，累及左肺、腹腔和纵隔淋巴结。尽管之前接受了姑息性放疗和以铂类为基础的化疗，并使用了 pembrolizumab 和西妥昔单抗，但使用 alpelisib 和 nivolumab 治疗后获得了部分应答。严重的高血糖和皮疹导致治疗中断：我们的研究结果凸显了这种创新疗法组合的潜力，表明有必要在这种情况下开展进一步研究。

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Alpelisib and Immunotherapy: A Promising Combination for Recurrent and Metastatic Squamous Cell Carcinoma of the Head and Neck

Background

Recurrent squamous cell carcinoma (SCC) of the head and neck (SCCHN) remains a formidable clinical challenge despite available treatments. The phosphatidylinositol 3-kinase (PI3K) pathway has been identified as a potential therapeutic target, and alpelisib, a selective PI3Kα inhibitor, has demonstrated efficacy in certain malignancies. Combining this targeted therapy with immunotherapy has been suggested in previous studies as a promising strategy to bolster the immune response against cancer.

Cases

A 69-year-old woman with locoregional recurrence of PIK3CA-mutated SCC of the left maxilla and cervical nodal metastases. Several chemotherapeutic regimens, including cisplatin, docetaxel, 5FU, chemoradiotherapy, and mono-immunotherapy, resulted in disease progression. Alpelisib combined with pembrolizumab led to a sustained response for 9 months. A 58-year-old man with recurrent metastatic PIK3CA-mutated SCC of the oropharynx, involving the left lung, hilar, and mediastinal lymph nodes. Despite prior palliative radiation and platinum-based chemotherapy with pembrolizumab and cetuximab, treatment with alpelisib and nivolumab resulted in a partial response. Severe hyperglycemia and rash led to treatment discontinuation.