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引用次数: 0
摘要
局部晚期(III 期或 IV 期)头颈部鳞状细胞癌(SCCHN)通常需要多模式治疗,包括手术、放疗和/或全身治疗(即化疗或靶向药物)的组合。表皮生长因子受体(EGFR)的表达已在 90% 以上的 SCCHN 病例中被检测到,并与生存率下降、放疗耐药、局部区域治疗失败和远处转移率升高相关。本文讨论了针对表皮生长因子受体(EGFR)联合放疗的几种策略。迄今为止,西妥昔单抗作为一种抗表皮生长因子受体(EGFR)单克隆抗体,是唯一一种被证明能提高放疗联合治疗总生存率的靶向药物。然而,考虑到表皮生长因子受体抑制剂存在多种原发性和获得性耐药机制,我们重点研究了表皮生长因子受体抑制剂的分子通路,以寻找提高肿瘤反应性的替代或补充策略。我们认为,将针对表皮生长因子受体通路的治疗与旨在提高免疫反应的药物相结合是一种很有前景的方法,值得进一步探索。
Radiotherapy plus EGFR inhibitors: synergistic modalities.
Locally advanced (stage III or IV) squamous cell carcinoma of the head and neck (SCCHN) often requires multimodal treatment, consisting of a combination of surgery, radiation, and/or systemic therapy, namely chemotherapy or targeted agents. The expression of the epidermal growth factor receptor (EGFR) has been detected in more than 90% of all cases of SCCHN and has been correlated with decreased survival rates, resistance to radiotherapy, loco-regional treatment failure, and increased rates of distant metastases. This paper discusses several strategies aimed at targeting EGFR in combination with radiation. Until now, cetuximab, an anti-EGFR monoclonal antibody, is the only targeted agent that has been shown to improve overall survival in combination with radiation therapy. However, considering that there are multiple mechanisms of primary and acquired resistance to EGFR inhibitors, we focused on dissecting molecular pathways of EGFR inhibition to find alternative or complementary strategies for increasing tumour responsiveness. We suggest that the combination of treatments targeting the EGFR pathway and drugs aimed at increasing immune responses represent a promising approach that deserves to be further explored.