This is an open access book.
With a wealth of exciting data emerging in this rapidly evolving field this book will review the state-of-the-art knowledge with emphasis on multidisciplinary decision and management of head and neck cancer. The book provides significant detail on a wide range of topics including: the role of new targets for treatment, immunotherapy, resistance mechanisms, standardizing molecular profiling programs, and new methods to guide therapeutic approaches. In addition different disease situations are addressed including different treatment approaches in primary disease and in recurrent and/or metastatic disease as well as new developments in pathology, surgery and reconstruction techniques, new systemic therapies in salivary gland cancer, and supportive care and follow-up.
All disciplines involved in the treatment of head & neck cancer are covered with a focus on translation into daily practice. The 8th-THNO is designed for medical oncologists, head and neck surgeons, radiation oncologists, otolaryngologists, and other medical professionals involved in the treatment of patients with head and neck cancer.
Author(s): Jan B. Vermorken, Volker Budach, C. René Leemans, Jean-Pascal Machiels, Piero Nicolai, Brian O'Sullivan
Publisher: Springer
Year: 2023
Language: English
Pages: 360
City: Cham
Preface
Contents
1 The Bi-Directional Communication Between Tumour Cells and Other Components of the Tumour Microenvironment
Introduction
Biomarkers
Autophagy
Development of AMBRA-1 as a Prognostic Biomarker
Sentinel Node Biopsy in Melanoma
Cross-talk Mechanism in Melanoma
Autophagy and Squamous Cell Carcinoma of the Head and Neck
Oropharyngeal Squamous Carcinoma
Cutaneous Squamous Cell Carcinoma
Conclusion
References
2 Immune Checkpoint Inhibition and Radiotherapy in Head and Neck Squamous Cell Carcinoma: Synergisms and Resistance Mechanisms
Introduction
Radiotherapy and Immunotherapy in HNSCC Treatment
Immunological Effects of Radiotherapy
Clinical Experiences with a Combination of Radiotherapy and Immune Checkpoint Inhibition in HNSCC
Conclusions
References
3 DNA Repair Mechanisms as a New Target in Head and Neck Cancer
Introduction
Immunostimulatory Effects Mediated by Radiotherapy
Immunosuppressive Mechanisms Triggered by Radiotherapy
Targeting DNA-Damage Response (DDR) Pathways
ATM and ATR Inhibitors
Immune Effects of ATR Inhibition
Conclusions
References
4 How to Standardize Molecular Profiling Programs for Routine Patient Care
Introduction
Relevant Aspects for Sample Collection and Processing
Clinical Next-Generation Sequencing
Targeted Gene Panel Sequencing
Clinical Interpretation of Molecular Alterations
Treatment and Follow-up
Conclusions
References
5 Novel Immune Oncology Targets Beyond PD-1/PD-L1 in Head and Neck Cancer
Introduction
Targeting Other Immune Checkpoints
Combination of Anti-immune Checkpoint MoAbs with Other Type of Molecules
Immunotherapeutic Vaccines for Human Papillomavirus (HPV)-Positive HNSCC
Immunotherapy in the Early Stage Setting
Conclusion
References
6 Understanding Head and Neck Cancer Evolution to Guide Therapeutic Approaches
Introduction
Evolution of Treatment Naïve HNSCC
Genomic Landscape of HNSCC
Mutational and Copy Number Signatures
Intra-tumoural Heterogeneity and Timing Evolutionary Events
Evolution and Considerations for Therapy in HNSCC
Developing Biomarkers and Therapies Informed by Evolution
Recurrent and Metastatic HNSCC—Evolution on Treatment
Circulating Tumour DNA
Conclusions
References
7 Sensitivity and Specificity of Extranodal Extension: Unlocking One of the Strongest Prognostic Factors in Head and Neck Cancer
Introduction
Pathological, Radiological, and Clinical Signs of ENE
Sensitivity and Specificity of rENE for pENE
Artificial Intelligence and Machine-Learning in Identifying rENE
Biomarkers Associated with ENE
Clinical Implication of ENE
Conclusion
References
8 Proton Therapy for Head and Neck Cancer
Introduction
Physical Properties of Proton Therapy
Dosimetric Benefits of Proton Therapy
Dosimetric Uncertainties of Proton Therapy for Head and Neck Patients
Patient Selection for Proton Therapy
Normal Tissue Complication Probability Models for Head and Neck Cancer
Model-Based Approach
Randomized Controlled Trials for Proton Therapy
Outcomes After Proton Therapy of Head and Neck Cancers
Skull-Base Chordomas and Chondrosarcomas
Sinonasal Cancers
Periorbital Tumours
Salivary Gland Cancer
Oropharyngeal Cancers
Nasopharyngeal Cancers
References
9 Treatment De-Escalation of HPV-Positive Oropharyngeal Cancer—Lessons Learnt from Recent Trials
Introduction
Why De-escalation?
Results of Recent De-escalation Trials
Lessons Learnt from De-escalation Studies
Conclusions
References
10 Treatment Intensification in Locoregionally Advanced Head and Neck Squamous Cell Carcinoma: What Are the Options and for Whom?
Introduction
Standard of Care Concurrent Chemoradiotherapy (CCRT)
Toxicity of Standard of Care Concurrent Chemoradiotherapy
Is Single Day Three-Weekly High-Dose Cisplatin Optimal to Enhance the Effect of Radiation?
Concurrent Chemoradiotherapy in HPV-Positive Oropharyngeal Cancer Patients
Treatment Intensification Beyond Concurrent Cisplatin- Based Chemoradiotherapy (summarized in Table 10.3)
Combining Altered Fractionation Radiotherapy with Chemotherapy
Adding More Cytotoxic Chemotherapy
Adding Targeted Therapy
Adding Approaches that Increase the Radio-Sensitivity of Hypoxic Cells
Adding Immunotherapy (Immune Checkpoint Inhibitors)
Conclusions
References
11 Immune Checkpoint Inhibitors in the Curative Setting: Pre-clinical and Clinical Data
Introduction
Anti-PD-1/PD-L1 mAbs in Combination with Curative-Intent Primary Surgery
Anti-PD-1/PD-L1 mAbs in Combination with Primary Curative-Intent (Chemo)Radiation
Conclusion
References
12 Carcinoma of Unknown Primary: Diagnostics and the Potential of Transoral Surgery
Introduction
History of Diagnostics in CUP
Recent and Current Improvements
Transoral Surgery—The Role of TLM and TORS
Where Does TBM Come In?
How to Perform TBM?
How to Analyze the Resection Specimen?
Extent of Resection
The Case of True CUP
Is TBM Really Indispensable?
Definitive Treatment
Conclusion
References
13 Systemic Treatment Sequencing and Prediction of First-line Therapy Outcomes in Recurrent or Metastatic Head and Neck Cancer
Introduction
Defining the First Line
First-Line Setting: Where it Begins and Ends
First-Line Treatment: Pros and Cons
Decision-Making Factors
Categorical Variables
Continuous Variables
Treatment Sequencing
Conclusions
References
14 Patterns of Response to Immune Oncology Drugs: How Relevant Are They in SCCHN?
Introduction
Immunotherapy in Head and Neck Cancer
Patterns of Response to Immune Checkpoint Inhibitors
Pseudoprogression
Hyperprogressive Disease (HPD)
Conclusions
References
15 Stereotactic Body Radiation Therapy in the Management of Recurrent and/or Oligometastatic Head and Neck Cancer
Introduction
Reirradiation Using SBRT in Recurrent or Second Primary Head and Neck Cancer
SBRT in HNC Patients with Oligometastatic Disease
Conclusion and Recommendations
References
16 Precision Medicine in the Treatment of Malignancies Involving the Ventral Skull Base: Present and Future
Introduction
Sinonasal Tumors
Intestinal-Type Adenocarcinoma
Squamous Cell Carcinoma
Olfactory Neuroblastoma
Mucosal Melanoma
Sinonasal Undifferentiated Carcinoma and SWI-SNF-Deficient Sinonasal Carcinomas
Sinonasal Neuroendocrine Carcinomas
Adenoid Cystic Carcinoma
Nasopharyngeal Tumors
Non-epithelial Skull Base Cancers
Chondrosarcoma
Chordoma
Conclusions
References
17 Modern Day Reconstruction of the Facial Bones
Introduction
Essential Steps
Indications
Resection
Mandibular Reconstruction
Maxillary Reconstruction
Limitations and Future Developments
Conclusion
References
18 Targeting Molecular Residual Disease Using Novel Technologies and Clinical Trials Design in Head and Neck Squamous Cell Cancer
Introduction
Liquid Biopsy and Molecular Residual Disease
Assays for MRD Detection
Evaluation of MRD in HNSCC
HPV DNA
Mutation-Based ctDNA
Methylated cfDNA
MRD Clinical Trials Design
Conclusions
References
19 New Developments in Surgery for Malignant Salivary Gland Tumors
Introduction
Developments in Ablative Surgery
Transoral Surgery: TLM and TORS
Transnasal Endoscopic Surgery
Developments in Reconstructive Surgery
Developments in Midface Reanimation
Developments in Single Stage Reconstruction of Complex Defects Using Free Flaps
Conclusion
References
20 New Systemic Therapies in Salivary Gland Cancer
Introduction
Subtypes of Salivary Gland Cancers
Adenoid Cystic Carcinoma
Mucoepidermoid Carcinoma
Salivary Duct Carcinoma
Mammary Analogue Secretory Carcinoma
Acinic Cell Carcinoma
Polymorphous Adenocarcinoma
Adenocarcinoma not Otherwise Specified (NOS)
Carcinoma ex Pleomorphic Adenoma
Other Subtypes
Immunotherapy
Conclusions
References
21 Exercise and Nutrition Interventions in Head and Neck Cancer
Introduction
Malnutrition and Nutritional Interventions
Immunonutrition
Physical Activity and Quality of Life
Prophylactic Measures
Conclusion and Recommendations
References
22 Digital Technologies in Supportive Head and Neck Cancer Care: A Promise?
Introduction
Supportive Care and Self-management
Digital Supportive Care
The Case of Oncokompas
Conclusion
References
