头颈部鳞癌免疫检查点抑制剂治疗专家共识

doi:10.7518/hxkq.2022.06.001

华西口腔医学杂志 ›› 2022, Vol. 40 ›› Issue (6): 619-628.doi: 10.7518/hxkq.2022.06.001

• 专家共识 • 下一篇

头颈部鳞癌免疫检查点抑制剂治疗专家共识

刘磊¹(), 向中正¹, 李一², 郭伟³, 杨凯⁴, 王军¹, 孙志军⁵, 任国欣³, 张建国⁶, 孙沫逸⁷, 冉伟⁸, 黄桂林⁹, 唐瞻贵¹⁰, 李龙江²()

^1.四川大学华西医院头颈肿瘤科，成都 610041
^2.口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医院头颈肿瘤外科，成都 610041
^3.上海交通大学医学院附属第九人民医院口腔颌面头颈肿瘤外科，上海 200011
^4.重庆医科大学附属第一医院口腔颌面外科，重庆 400016
^5.武汉大学口腔医院口腔颌面外科，武汉 430079
^6.北京大学口腔医院口腔颌面外科，北京 100081
^7.空军医科大学口腔医院口腔颌面外科，西安 710032
^8.中山大学附属第一医院口腔颌面外科，广州 510080
^9.遵义医科大学口腔医院口腔颌面外科，遵义 563000
^10.中南大学湘雅口腔医院口腔颌面外科，长沙 410000

收稿日期:2022-04-11 修回日期:2022-09-18 出版日期:2022-12-01 发布日期:2022-11-23
通讯作者: 李龙江 E-mail:liuleihx@gmail.com;muzili63@163.com
作者简介:刘磊，教授，博士，E-mail：liuleihx@gmail.com|刘磊，教授，博士研究生导师，四川大学华西医院肿瘤中心头颈肿瘤病房主任。主要从事头颈肿瘤的放射治疗和综合治疗。学术任职包括：中国临床肿瘤学会（ChineseSociety of Clinical Oncology，CSCO）头颈肿瘤专业委员会委员、中国医师协会放疗分会鼻咽癌学组委员、中国医师协会放疗分会中枢神经系统肿瘤学组委员、中国抗癌协会鼻咽癌专业委员会委员、中国医促会鼻咽癌分会委员等；以通讯作者发表SCI 论文60 余篇，ESI 高引论文2 篇，2 篇论文被美国国立综合癌症网络（National Comprehensive CancerNetwork，NCCN）指南引用；主持国家自然科学基金等多项国家级和省部级课题；参与多个指南的编制，包括：《中国临床肿瘤学会（CSCO）头颈部肿瘤诊疗指南》《乳腺癌放射治疗指南》《中国鼻咽癌放射治疗指南》等。E-mail：liuleihx@gmail.com|李龙江，四川大学华西口腔医院头颈肿瘤外科主任医师，教授，博士生导师。中华口腔医学会口腔颌面-头颈肿瘤专业委员会候任主任委员，中华口腔医学会口腔颌面外科专业委员会副主任委员，中国抗癌协会口腔颌面肿瘤整合医学专业委员会副主任委员，中国抗癌协会头颈肿瘤外科专业委员会常委，四川省口腔颌面外科专业委员会主任委员，四川省医学科技创新研究会会长，四川省领军人才，四川省学术和技术带头人，四川省有突出贡献的优秀专家。2008 年作为客座教授在德国汉堡大学研修，Human GeneTherapy、Int J Oral Sci、《中华口腔医学杂志》和《中国肿瘤学杂志》等10 余种专业杂志编委。承担国家重大研发项目4 项，负责国家自然科学基金项目8 项，获得国家科技进步二等奖1 项，省部级科技进步二等奖5 项。先后完成了口腔癌发病机制及生物学行为特征，综合治疗、生物治疗、颌面部组织器官缺损的优化修复重建、涎腺肿瘤疾病的发病机理等科研内容。发表论文300 余篇，SCI 收录100 余篇。E-mail：muzili63@163.com
基金资助:
国家自然科学基金肿瘤专项(82141130)

The immune checkpoint inhibitors treatment of head and neck squamous cell carcinoma: an expert consensus

Liu Lei¹(), Xiang Zhongzheng¹, Li Yi², Guo Wei³, Yang Kai⁴, Wang Jun¹, Sun Zhijun⁵, Ren Guoxin³, Zhang Jianguo⁶, Sun Moyi⁷, Ran Wei⁸, Huang Guilin⁹, Tang Zhangui¹⁰, Li Longjiang²()

^1.Dept. of Head and Neck Oncology, West China Hospital of Sichuan University, Chengdu 610041, China
^2.State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
^3.Dept. of Oral and Maxillofacial-head and Neck Oncology, Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
^4.Dept. of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
^5.Dept. of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
^6.Dept. of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
^7.Dept. of Oral and Maxillofacial Surgery, Hospital of Stomatology, Air Force Medical University, Xi’an 710032, China
^8.Dept. of Oral and Maxillofacial Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
^9.Dept. of Oral and Maxillofacial Surgery, Stomatological Hospital, Zunyi Medical University, Zunyi 563000, China
^10.Dept. of Oral and Maxillofacial Surgery, Xiangya School of Stomatology, Central South University, Changsha 410000, China

Received:2022-04-11 Revised:2022-09-18 Online:2022-12-01 Published:2022-11-23
Contact: Li Longjiang E-mail:liuleihx@gmail.com;muzili63@163.com
Supported by:
National Natural Science Foundation of China Cancer Program(82141130);Correspondence: Li Long-jiang, E-mail: muzili63@163.com

摘要/Abstract

摘要：

近年来免疫检查点抑制剂（ICIs）在恶性肿瘤治疗中有着突破性进展，并迅速被批准作为多系统恶性肿瘤的一线治疗方案。在头颈部鳞癌中，帕博利珠单抗单药或联合化疗方案已被国内外指南推荐用于复发/转移头颈部鳞癌的一线治疗。虽然ICIs在头颈部鳞癌治疗中有里程碑的意义，但当前仍然存在诸多需要重视的问题，如ICIs疗效预测因子的选择，肿瘤病灶对ICIs治疗反应的评价，免疫超进展的应对以及免疫相关不良反应的处理等。因此，本共识基于当前临床已有的循证医学依据，结合临床上关注的热点问题进行深入探讨，整合头颈部肿瘤各专业领域专家的临床工作经验而形成相对规范统一的认识。

关键词: 头颈部鳞癌, 免疫治疗, 免疫检查点抑制剂, 专家共识

Abstract:

Immune checkpoint inhibitors (ICIs) present significant efficacy in the treatment of malignant tumors, and they have been approved as the first-line of treatment for various cancers. Pembrolizumab monotherapy or combined with chemotherapy has been recommended by domestic and foreign guidelines for the first-line treatment of recurrent/metastatic head and neck squamous cell carcinoma. Although ICIs represent a milestone in the treatment of head and neck squamous cell carcinoma, potential problems still need to be addressed, such as the selection of the efficacy predictors for ICIs, the evaluation of the tumor response to ICIs, and the treatment of immune hyperprogression and immune-related adverse events. Therefore, to form a relatively unified understanding of ICIs treatment for head and neck squamous cell carcinoma, we integrated the clinical experience of multi-disciplinary experts of head and neck cancers on the basis of current clinical hot issues and finally developed this consensus.

Key words: head and neck squamous cell carcinoma, immunotherapy, immune checkpoint inhibitors, expert consensus

中图分类号:

R 739.8

刘磊, 向中正, 李一, 郭伟, 杨凯, 王军, 孙志军, 任国欣, 张建国, 孙沫逸, 冉伟, 黄桂林, 唐瞻贵, 李龙江. 头颈部鳞癌免疫检查点抑制剂治疗专家共识[J]. 华西口腔医学杂志, 2022, 40(6): 619-628.

Liu Lei, Xiang Zhongzheng, Li Yi, Guo Wei, Yang Kai, Wang Jun, Sun Zhijun, Ren Guoxin, Zhang Jianguo, Sun Moyi, Ran Wei, Huang Guilin, Tang Zhangui, Li Longjiang. The immune checkpoint inhibitors treatment of head and neck squamous cell carcinoma: an expert consensus[J]. West China Journal of Stomatology, 2022, 40(6): 619-628.

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头颈部鳞癌免疫检查点抑制剂治疗专家共识

The immune checkpoint inhibitors treatment of head and neck squamous cell carcinoma: an expert consensus

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