耳鼻咽喉科・頭頸部外科90巻3号

2018年03月発行

特集 頭頸部癌に対する薬物療法—最新情報

切除不能再発・転移頭頸部癌に対する薬物療法

著者： 今村善宣¹

所属機関： ¹神戸大学医学部附属病院腫瘍・血液内科

ページ範囲：P.233 - P.237

文献概要

POINT

●再発・転移例の治療目標は延命・緩和であり，薬物療法の適応ならびに薬剤選択を慎重に検討する。

●一次治療として，5-FU＋プラチナ系薬剤の併用療法に対するセツキシマブの上乗せ効果がEXTREME試験で示されており，現在の標準治療となっている。

●プラチナ抵抗例に対して，ニボルマブの有効性と安全性がCheckMate 141試験で示され，新たな標準治療となった。

●プラチナ抵抗性とは，化学放射線療法や一次治療としてプラチナ系薬剤を使用してから6か月以内に再発・進行をきたした場合を指す。

参考文献

1）Kowalski LP, et al：Natural history of untreated head and neck cancer. Eur J Cancer 36：1032-1037, 2000

2）Morton RP, et al：Cisplatinum and bleomycin for advanced or recurrent squamous cell carcinoma of the head and neck：a randomised factorial phase Ⅲ controlled trial. Cancer Chemother Pharmacol 15：283-289, 1985

3）Armand JP, et al：Chemotherapy in head and neck cancer. Eur J Cancer 31A：819-822, 1995

4）Forastiere AA, et al：Randomized comparison of cisplatin plus fluorouracil and carboplatin plus fluorouracil versus methotrexate in advanced squamous-cell carcinoma of the head and neck：a Southwest Oncology Group study. J Clin Oncol 10：1245-1251, 1992

5）Jacobs C, et al：A phase Ⅲ randomized study comparing cisplatin and fluorouracil as single agents and in combination for advanced squamous cell carcinoma of the head and neck. J Clin Oncol 10：257-263, 1992

6）Vermorken JB, et al：Platinum-based chemotherapy plus cetuximab in head and neck cancer. N Engl J Med 359：1116-1127, 2008

7）Mesia R, et al：Quality of life of patients receiving platinum-based chemotherapy plus cetuximab first line for recurrent and/or metastatic squamous cell carcinoma of the head and neck. Ann Oncol 21：1967-1973, 2010

8）Yoshino T, et al：Platinum-based chemotherapy plus cetuximab for the first-line treatment of Japanese patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck：results of a phase Ⅱ trial. Jpn J Clin Oncol 43：524-531, 2013

9）Hitt R, et al：Phase Ⅱ study of the combination of cetuximab and weekly paclitaxel in the first-line treatment of patients with recurrent and/or metastatic squamous cell carcinoma of head and neck. Ann Oncol 23：1016-1022, 2012

10）Sacco AG, et al：Current treatment options for recurrent or metastatic head and neck squamous cell carcinoma. J Clin Oncol 33：3305-3313, 2015

11）Ferris RL, et al：Nivolumab for recurrent squamous-cell carcinoma of the head and neck. N Engl J Med 375：1856-1867, 2016

12）Harrington KJ, et al：Nivolumab versus standard, single-agent therapy of investigator's choice in recurrent or metastatic squamous cell carcinoma of the head and neck（CheckMate 141）：health-related quality-of-life results from a randomised, phase 3 trial. Lancet Oncol 18：1104-1115, 2017

13）Kiyota N, et al：A randomized, open-label, Phase Ⅲ clinical trial of nivolumab vs. therapy of investigator's choice in recurrent squamous cell carcinoma of the head and neck：A subanalysis of Asian patients versus the global population in checkmate 141. Oral Oncol 73：138-146, 2017

14）Ferris RL：Immunology and Immunotherapy of Head and Neck Cancer. J Clin Oncol 33：3293-3304, 2015

15）Cohen EEW, et al：Pembrolizumab（pembro）vs standard of care（SOC）for recurrent or metastatic head and neck squamous cell carcinoma（R/M HNSCC）：Phase 3 KEYNOTE-040 trial. Presented at ESMO 2017 Congress；September 8-12, 2017；Madrid, Spain. Abstract LBA45_PR.