Head and neck squamous cell carcinoma
- Study type
- Review article
- Study name
- HNSCC Primer
- Design
- Review article (Primer) in Nature Reviews Disease Primers; not a primary clinical study
- Source
- Nat Rev Dis Primers · 2020
In plain words
Most head and neck cancers start in the cells lining the inside of the mouth, throat (pharynx) and voice box (larynx). Cancers of the mouth and voice box are mostly linked to tobacco and alcohol, and throat cancer is increasingly linked to infection with the HPV virus. Treatment is usually combined: surgery and chemoradiotherapy, or chemoradiotherapy alone, depending on where the tumour is. Immunotherapy drugs have also been approved for disease that has come back or spread and, in some cases, for disease that cannot be operated on. Research is trying to find more effective treatments with fewer side effects for each patient.
Study population
This paper is a review and did not enrol specific patients. Its subject is head and neck squamous cell carcinoma (HNSCC), which arises from the mucosal epithelium of the oral cavity, pharynx and larynx.
Endpoints
This paper is a review and has no primary or secondary endpoint. The abstract covers: epidemiology and risk factors (tobacco, alcohol, HPV), the differences between HPV-negative and HPV-positive HNSCC, staging, multimodal treatment, immunotherapy and predictive biomarkers.
Safety and side effects
The abstract gives no quantitative information on treatment adverse effects. Only the general aim of "delivering the most effective treatments with the least toxicity" is mentioned.
Clinical significance and place in guidelines
This review provides an overall framework for HNSCC: division of the disease into HPV-negative and HPV-positive, use of the 2017 AJCC/UICC staging system, multimodal treatment (surgery and CRT for the oral cavity; primary CRT for the pharynx and larynx), use of cetuximab with radiotherapy in HPV-negative HNSCC when cytotoxic chemotherapy is contraindicated, and FDA approval of pembrolizumab and nivolumab in recurrent or metastatic disease and of pembrolizumab for first-line treatment of unresectable disease. Because this is a review published in 2020, the latest reliable clinical guidelines and drug approval status should be checked for clinical decisions.
Limitations
This paper is a narrative review and has no primary data or systematic analysis. An erratum to the paper was published in 2023. The abstract gives no exact doses or treatment regimens, and the information on approvals reflects the time of publication (2020) and may be out of date.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.