Current Standards for Organ Preservation in Locoregionally Advanced Non-nasopharyngeal Head and Neck Cancer and Evolving Strategies for Favorable-Risk and Platinum-Ineligible Populations

Opinion statementStandard-of-care treatment for the majority of patients with locoregionally advanced squamous cell carcinoma of the head and neck (SCCHN) is either upfront surgery followed by adjuvant treatment as indicated by intraoperative or pathologic findings or concurrent chemoradiation reserving surgical salvage for non-responsive disease. An attempt at upfront complete resection should be pursued if feasible in patients with oral cavity or paranasal sinus primary tumors. Given multimodality treatment paradigms, patients with locoregionally advanced SCCHN should be managed in a multidisciplinary setting. Modern radiation therapy, whether postoperative or definitive in intent, is based on target delineation guided by high-quality imaging, using an intensity-modulated radiation technique to spare organs at risk. In select groups of low-risk patients, most notably those with HPV-associated oropharyngeal SCC (OPSCC), several treatment deintensification approaches are currently under investigation. Major experimental strategies within this non-surgical organ preservation domain include reductions in the intensity of the chemotherapy or radiation therapy components of the chemoradiation program, use of induction chemotherapy, or imaging-based selection of patients eligible for deintensified radiation-based treatment. Of note, recent efforts to substitute cetuximab for cisplatin in low-risk HPV-associated OPSCC have demonstrated the inferiority of cetuximab to cisplatin in c...
Source: Current Treatment Options in Oncology - Category: Cancer & Oncology Source Type: research

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AbstractHead and neck cancers, including those of the lip and oral cavity, nasal cavity, paranasal sinuses, oropharynx, larynx and nasopharynx represent nearly 700,000 new cases and 380,000 deaths worldwide per annum, and account for over 10,000 annual deaths in the United States alone. Improvement in outcomes are needed for patients with recurrent and or metastatic squamous cell carcinoma of the head and neck (HNSCC). In 2016, the US Food and Drug Administration (FDA) granted the first immunotherapeutic approvals – the anti-PD-1 immune checkpoint inhibitors nivolumab and pembrolizumab – for the treatment of pa...
Source: Journal for Immunotherapy of Cancer - Category: Cancer & Oncology Source Type: research
Conditions:   Head and Neck Basaloid Carcinoma;   Recurrent Head and Neck Squamous Cell Carcinoma;   Recurrent Oropharyngeal Squamous Cell Carcinoma;   Squamous Cell Carcinoma of Unknown Primary Origin;   Stage IV Lip and Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7;   Stage IV Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma AJCC v7;   Stage IV Nasopharyngeal Keratinizing Squamous Cell Carcinoma AJCC v7;   Stage IV Oropharyngeal Squamous Cell Carcinoma AJCC v7;   St...
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Squamous cell carcinoma (SCC) is the most common malignancy of head and neck region arising from mucosal linings of the upper aerodigestive tract, comprising (1) nasal cavity and paranasal sinuses, (2) nasopharynx, (3) hypopharynx, larynx, and trachea, and (4) oral cavity and oropharynx [1,2]. Head and neck squamous cell carcinomas (HNSCC) are characterized by high morbidity and mortality rates and strong tendency to regional and distant metastasis [1–4]. These tumor characteristics depend on individual properties of neoplastic cells and tumor microenvironment, which is comprised by diverse inflammatory/immune cells ...
Source: Oral Oncology - Category: Cancer & Oncology Authors: Tags: Review Source Type: research
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