Special tumor entities in the head and neck region: nasopharyngeal, salivary gland, and thyroid cancer

• Published in: HNO Vol. 71; no. 7; pp. 453 - 461
• Main Authors: Zech, Henrike B, Betz, Christian S
• Format: Journal Article
• Language: German
• Published: Germany 01.07.2023
• Subjects: Chemoradiotherapy; Clinical Trials, Phase II as Topic; Epstein-Barr Virus Infections; Herpesvirus 4, Human; Humans; Nasopharyngeal Neoplasms - diagnosis; Nasopharyngeal Neoplasms - pathology; Nasopharyngeal Neoplasms - therapy; Salivary Glands - pathology; Thyroid Neoplasms - diagnosis; Thyroid Neoplasms - therapy; Immunological antineoplastic agents; Intensity-modulated radiotherapy; Molecular target therapy; Chemoradiotherapy; Drug toxicity
• ISSN: 1433-0458
• DOI: 10.1007/s00106-023-01312-y

At the meetings of the American Society of Clinical Oncology (ASCO) and the European Society for Medical Oncology (ESMO) in 2022, studies were presented which suggest changes in the clinical routine of nasopharyngeal, salivary gland, and thyroid cancer. Therapeutic innovations for special otorhinolaryngological tumor entities with potential clinical relevance were assessed after reviewing the studies presented at the ASCO 2022/ESMO 2022 meetings. The presented clinical phase II and phase III studies were analyzed. Results were classified according to their potential clinical importance, taking into account current treatment standards. Three studies were presented that dealt with the topic of risk-adapted treatment stratification in advanced nasopharyngeal cancer. Dose-reduced radiotherapy (60 Gy) in low-risk patients resulted in a favorable toxicity profile with promising oncological results in a single-arm phase II study. In a phase III study, intensity-modulated radiotherapy alone showed comparable survival to combined radiochemotherapy with cisplatin in selected low-risk patients. In high-risk patients, addition of the EGFR antibody nimotuzumab to definitive radiochemotherapy showed an increased 5‑year survival rate compared to placebo (phase III study). Although an immediate change in clinical practice in Europe based on these studies is questionable, the concept of risk-adapted therapy taking into account biological characteristics (Epstein-Barr virus [EBV] DNA level) is future orientated. Similar to previous years, the contributions on recurrent/metastatic salivary gland and thyroid cancer emphasized the importance of targeted therapies based on vulnerable molecular target lesions.