可切除HNSCC围手术期免疫治疗的基础和临床证据
Basic and Clinical Evidence for Perioperative Immunotherapy in Resectable HNSCC.
摘要(中文译文)
围手术期免疫治疗已成为改善可切除头颈部鳞状细胞癌（HNSCC）患者预后的一种有前景的策略。然而，其生物学依据、临床证据及最佳实施方式仍未被完全明确。我们对当前文献进行了叙述性综述，整合了围手术期免疫检查点抑制剂（ICI）治疗可切除HNSCC的临床前和临床证据，特别关注手术的免疫学影响、肿瘤引流淋巴结及治疗顺序。新辅助免疫治疗利用完整肿瘤抗原的存在和保留的淋巴结构，使广泛的T细胞致敏、克隆扩增和全身免疫记忆形成成为可能。相比之下，辅助免疫治疗主要针对残留的微小病灶，并依赖于预先存在的肿瘤反应性T细胞，提示这两种策略在生物学上存在差异。早期临床试验已证实围手术期ICI的安全性和可行性，并有病理缓解的证据。近期III期试验，包括KEYNOTE-689和NIVOPOSTOP，提供了支持将ICI整合入围手术期治疗的实践相关证据，显示在特定人群中无事件生存期和临床结局得到改善。仍存在若干挑战，包括最佳患者选择、缺乏经过验证的生物标志物以及围手术期ICI暴露后的治疗顺序。围手术期免疫治疗是可切除HNSCC中一种有前景且具有实践相关性的策略。需要进一步研究以完善患者选择、开发预测性生物标志物并优化治疗顺序，从而最大化临床获益。
Abstract
: Perioperative immunotherapy has emerged as a promising strategy for improving outcomes in patients with resectable head and neck squamous cell carcinoma (HNSCC). However, its biological rationale, clinical evidence, and optimal implementation remain incompletely defined. : We conducted a narrative review of the current literature, integrating preclinical and clinical evidence on perioperative immune checkpoint inhibitor (ICI) therapy in resectable HNSCC, with particular attention to the immunological impact of surgery, tumor-draining lymph nodes, and treatment sequencing. : Neoadjuvant immunotherapy exploits the presence of intact tumor antigen and preserved lymphatic architecture, enabling broad T-cell priming, clonal expansion, and systemic immune memory formation. In contrast, adjuvant immunotherapy primarily targets residual microscopic disease and relies on preexisting tumor-reactive T cells, suggesting that these strategies are biologically distinct. Early-phase clinical trials have demonstrated the safety and feasibility of perioperative ICIs, with evidence of pathological responses. Recent phase III trials, including KEYNOTE-689 and NIVOPOSTOP, have provided practice-relevant evidence supporting the integration of ICIs into perioperative treatment, demonstrating improved event-free survival and clinical outcomes in selected populations. Several challenges remain, including optimal patient selection, lack of validated biomarkers, and treatment sequencing after perioperative ICI exposure. : Perioperative immunotherapy represents a promising practice-relevant strategy in resectable HNSCC. Further studies are required to refine patient selection, develop predictive biomarkers, and optimize treatment sequencing to maximize clinical benefit.
如何引用
AMA
Shota Sakaue, Michihisa Kono, Takumi Kumai, Takahiro Inoue, Hisataka Ominato, Miki Takahara. Basic and Clinical Evidence for Perioperative Immunotherapy in Resectable HNSCC.. Cancers. 2026; doi:10.3390/cancers18111845.
APA
Shota Sakaue, Michihisa Kono, Takumi Kumai, Takahiro Inoue, Hisataka Ominato, Miki Takahara (2026). Basic and Clinical Evidence for Perioperative Immunotherapy in Resectable HNSCC.. Cancers. https://doi.org/10.3390/cancers18111845
GB/T 7714
Shota Sakaue, Michihisa Kono, Takumi Kumai, Takahiro Inoue, Hisataka Ominato, Miki Takahara. Basic and Clinical Evidence for Perioperative Immunotherapy in Resectable HNSCC.[J]. Cancers, 2026 doi:10.3390/cancers18111845.
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