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Adaptive Responses to Monotherapy in Head and Neck Cancer: Interventions for Rationale-Based Therapeutic Combinations.
- Source :
-
Trends in cancer [Trends Cancer] 2019 Jun; Vol. 5 (6), pp. 365-390. Date of Electronic Publication: 2019 May 28. - Publication Year :
- 2019
-
Abstract
- Most Phase II and III clinical trials in head and neck cancer (HNC) combine two or more treatment modalities, which are based, in part, on knowledge of the molecular mechanisms of innate and acquired resistance to monotherapy. In this review, we describe the range of tumor-cell autonomously derived (intrinsic) and tumor-microenvironment-derived (extrinsic) acquired-resistance mechanisms to various FDA-approved monotherapies for HNC. Specifically, we describe how tumor cells and the tumor microenvironment (TME) respond to radiation, chemotherapy, targeted therapy (cetuximab), and immunotherapies [programmed cell death 1 (PD-1) inhibitors] and adapt to the selective pressure of these monotherapies. Due to the diversity of adaptive responses to monotherapy, monitoring the response to treatment in patients is critical to understand the path that leads to resistance and to guide the optimal therapeutic drug combinations in the clinical setting. We envisage that applying such a rationale-based therapeutic strategy will improve treatment efficacy in HNC patients.<br /> (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Subjects :
- Antineoplastic Agents pharmacology
Antineoplastic Agents therapeutic use
Biomarkers, Tumor
Clinical Trials as Topic
Drug Resistance, Neoplasm
Head and Neck Neoplasms etiology
Head and Neck Neoplasms metabolism
Head and Neck Neoplasms pathology
Humans
Immunotherapy
Molecular Targeted Therapy
Radiation Tolerance
Radiotherapy
Signal Transduction
Treatment Outcome
Tumor Microenvironment drug effects
Tumor Microenvironment genetics
Tumor Microenvironment immunology
Tumor Microenvironment radiation effects
Adaptation, Biological drug effects
Adaptation, Biological radiation effects
Head and Neck Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 2405-8025
- Volume :
- 5
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Trends in cancer
- Publication Type :
- Academic Journal
- Accession number :
- 31208698
- Full Text :
- https://doi.org/10.1016/j.trecan.2019.04.004