• N Brix, L Dunn, T Seiwert, C Belka, and K Lauber.
• Klinik für Strahlentherapie und Radioonkologie, LMU Klinikum der Universität München, Marchioninistr. 15, 81377, München, Deutschland.
• Internist (Berl). 2020 Jul 1; 61 (7): 682-689.

BackgroundThe clinical implementation of immunotherapy has broadened the therapeutic options for recurrent and/or metastatic head and neck squamous cell carcinoma (HNSCC). Until 2016, the only molecularly targeted therapy was epidermal growth factor receptor (EGFR) blockade. However, immune checkpoint inhibition has recently become part of first-line treatment in recurrent and/or metastatic HNSCC.ObjectivesThe occurrence of abscopal effects of radiotherapy and synergisms between immunotherapy and chemotherapy as well as the phenomenon of pseudoprogression in HNSCC were investigated.Materials And MethodsKey publications of recent clinical trials and preclinical studies on the underlying biological mechanisms were analyzed.ResultsAs already observed in other tumor entities, synergistic effects upon combination of immunotherapy with radio- and/or chemotherapy are observed in the clinical management of recurrent and/or metastatic HNSCC, and this is mediated by (re)activation of host antitumor immune mechanisms. In selected patients, this may be radiologically detected as pseudoprogression. Reliable biomarkers for these phenomena have not yet been clinically established.ConclusionsFor recurrent and/or metastatic HNSCC, the occurrence of systemic effects upon radiochemoimmunotherapy in the clinic is on the rise. Hence, the identification of biomarkers for abscopal effects of radiotherapy and unexpected synergisms between chemotherapy and immunotherapy as well as for pseudoprogression is gaining in importance.

17 keywords...

hide…