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Erschienen in: memo - Magazine of European Medical Oncology 4/2020

12.11.2020 | short review

Established treatment concepts for recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSSC)

verfasst von: MD Marcel Kloppenburg, Finn Mildner, Maria Theresia Kasseroler, Daniel Dejaco, Arno Amann

Erschienen in: memo - Magazine of European Medical Oncology | Ausgabe 4/2020

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Summary

Background

Recurrent and metastatic squamous cell carcinomas of the head and neck are still difficult to treat. The EXTREME regimen has been the standard of care for the last decade, but recent studies initiated a change. In this work we provide an overview of the established treatment concepts for recurrent and metastatic squamous cell carcinomas of the head and neck with palliative intent.

Material and methods

We performed a literature search using the key words: recurrent, metastatic, cancer, head and neck, HNSCC, treatment, chemotherapy, immunotherapy, salvage, and surgery. Furthermore, the presentations of the ASCO highlights of head and neck cancer from 2019 and 2020 were included.

Results

The KEYNOTE-048 and the TPEx randomized trial are the most relevant trials in the first line setting. The CheckMate 141 and KEYNOTE-040 have the greatest impact for the second line regimen.

Conclusion

The expression of PD-L1, prior treatment, performance status, local symptoms and tumor burden are the most important factors regarding choice of treatment. Pembrolizumab alone or in combination with chemotherapy can be recommend as the 1st line standard in patients with combined positive score (CPS) ≥20. The choice of therapy in patients with CPS 1-19 and CPS <1 has to be individually evaluated for each patient. Furthermore, TPEx is an encouraging alternative to the EXTREME regimen with less toxicity and improved quality of life.
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Metadaten
Titel
Established treatment concepts for recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSSC)
verfasst von
MD Marcel Kloppenburg
Finn Mildner
Maria Theresia Kasseroler
Daniel Dejaco
Arno Amann
Publikationsdatum
12.11.2020
Verlag
Springer Vienna
Erschienen in
memo - Magazine of European Medical Oncology / Ausgabe 4/2020
Print ISSN: 1865-5041
Elektronische ISSN: 1865-5076
DOI
https://doi.org/10.1007/s12254-020-00645-6