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The rationale for including immune checkpoint inhibition into multimodal primary treatment concepts of head and neck cancer

机译：将免疫检查点抑制纳入头颈癌多式联运基本治疗概念的基本原理

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Background Treatment of locally advanced squamous cell carcinomas of the head and neck (SCCHN) remains unsatisfactory. Although the addition of concurrent radiochemotherapy (RCT) or the combination of radiotherapy with blockade of the epidermal growth factor receptor (EGFR) have improved outcomes over radiotherapy alone, further optimization is urgently needed. The introduction of immune checkpoint inhibitors is currently revolutionizing cancer treatment. Clinical evidence has recently been provided in melanoma that immune checkpoint blockade may cooperate with radiation. Therefore, we searched in the literature for the evidence of combining immune checkpoint inhibitors with radiotherapy in primary treatment of SCCHN. Discussion A substantial amount of previous studies has dissected the molecular mechanisms of immune evasion in SCCHN. The biological effects of radio- and chemotherapy in tumor cells and the immune cell microenvironment were characterized in detail, revealing significant interference of both types of treatment with anti-tumor immunity. This extensive review of the literature revealed considerable amount of evidence that addition of immune checkpoint inhibitors might boost the immunomodulatory potential of radiotherapy and RCT regimens in SCCHN. Summary Promising activity of immune checkpoint inhibitors has already been reported for metastatic/recurrent SCCHN. Given the immunogenic effect of radiotherapy and its enhancement by chemotherapy, combination of radiotherapy or RCT with this new type of immunotherapy might represent a valuable option for improvement of curative treatment modalities in SCCHN.
机译：背景技术治疗局部晚期的头颈部鳞状细胞癌（SCCHN）仍然不能令人满意。尽管同时放疗（RCT）或放疗与表皮生长因子受体（EGFR）阻断相结合比单独放疗具有更好的疗效，但迫切需要进一步优化。免疫检查点抑制剂的引入目前正在彻底改变癌症的治疗方法。最近在黑素瘤中提供了临床证据，即免疫检查点封锁可能与放射线协同作用。因此，我们在文献中搜索了将免疫检查点抑制剂与放疗相结合用于SCCHN一级治疗的证据。讨论大量先前的研究已经剖析了SCCHN中免疫逃逸的分子机制。放射和化学疗法在肿瘤细胞和免疫细胞微环境中的生物学作用得到了详细描述，揭示了两种抗肿瘤免疫治疗的显着干扰。对文献的广泛审查显示，大量证据表明，添加免疫检查点抑制剂可能会增强SCCHN中放疗和RCT方案的免疫调节潜力。小结对于转移性/复发性SCCHN，已经报道了免疫检查点抑制剂的有希望的活性。鉴于放疗的免疫原性作用及其通过化学疗法的增强，放疗或RCT与这种新型免疫疗法的结合可能代表了改善SCCHN的治疗方法的宝贵选择。

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