medigraphic.com

2002, Number 6

<< Back Next >>

Cir Cir 2002; 70 (6)

Use of different immunotherapy combinations in patients with recurrent head and neck cancer. Experience of the National Cancer Institute

Barrera-Franco JL, Verastegui-Avilés E

Language: Spanish
References: 41
Page: 399-407
PDF size: 145.33 Kb.


ABSTRACT

Introduction: Local recurrence is one of the major causes of death in patients with advanced squamous cell carcinoma of head and neck. The possibility of additional therapy is not always feasible due to anatomic characteristics of the area and because high radiation dosage has already been administered. Patients under these conditions have poor quality of life. Material and methods: Use of immunologic approaches for the treatment of squamous cell carcinoma of head and neck has improved survival in an neoadjuvant setting. However, in patients with severe lymphopenia no effects have been noticed. With the purpose to evaluate several biological treatments (cytokine mixture, thalidomide, thymosin alpha) in patients with advanced disease, we decided to begin a pilot study for lymphopenic patients with recurrent head and neck carcinoma. Results: Thirty one consecutive patients were included to receive (a) a natural cytokine mixture, (b) cytokine mixture and thymosin alpha, (c) thalidomide, or (d) thalidomide and cytokine mixture. Short-term clinical responses were obtained in 18 patients and in all patients, symptomatic palliation. The combination of thalidomide with cytokines induced increase in total lymphocyte counts. The present work illustrates an additional approach in the treatment of multi treated, recurrent, head and neck cancer patients.


REFERENCES

  1. Shantz S, Harrison LB, Forastiere AA. Tumors of the nasal cavity and paranasal sinuses, nasopharynx, oral cavity and oropharyrix In: De Vita VT, Hellman S, Rosenberg SA, editors. Cancer principles and practice of oncology. 5th ed Philadelphia, PA, USA: JB Lippincott; 1997.pp.74l-801.

  2. Decker J, Goldstein JC. Risk factors in head and neck cancer. N Engl J Med 1982;306:1151-1155.

  3. Falk RT, Pickle LW, Brown LM, Mason TJ, et al. Effect of smoking and alcohol consumption on laryngeal cancer risk in coastal Texas. Cancer Res 1989;49:4024-4029.

  4. Saranath D, Panchal RG, Nair R, et al. Oncogene amplification in squamous cell carcinoma of the oral cavity. Jpn J Cancer Res 1989;80:430-437.

  5. Henle G, Henle W. Epstein-Barr virus specific IgA serum antibodies as an outstanding feature of nasopharyngeal carcinoma. Intl J Cancer 1976;17:1-7.

  6. Watts SL, Brewer EE, Fry TL. Human papillomavirus DNA types in squamous cell carcinoma of the head and neck. Oral Sur Oral Med Oral Pathol 1991;71:701-707.

  7. Schantz SP, Hsu TC, Ainsle N, Moser RP. Young adults with head and neck cancer express increased susceptibility to mutagen induced chromosome damage. JAMA 1989;49:4626-4628.

  8. Jacobson PA, Eneroch CM, Killander D, et al. Histologic classification and grading of malignancy in carcinoma of the larynx (a pilot study). Acta Radiol Ther Phys Biol 1979;12:1.

  9. Slaughter DP, Southwick HW, Smejkal W, Field. Cancerization in oral stratified squamous epithelium: clinical implications of multicentric origin. Cancer 1953;6:963-968.

  10. Vokes EE, Weichselbaum RH, Lippman SM, Ki Hong W. Head and neck cancer. N Engl J Med 1993; 328:184-194.

  11. Berlinger NT. Deficient immunity in head and neck cancer due to excessive monocyte production of prostaglandins. Laryngoscope 1984;94:1407-1410.

  12. Hadden JW. The immunopharmacology of head and neck cancer: An update. Int J immunopharmacol 1997;19:629-644.

  13. O’Sullivan G, Corbett AR, Sdhanahan F, Colins K. Regional immune suppression in esophageal squamous cancer. Evidence from functional studies with matched lymph nodes. J Immunol 1996;157:4717-4720.

  14. McLaughlin JK, Gridley G, Bock G, et al. Dietary factors in oral and pharyngeal cancer. J Natl Canc Inst 1988;80:1237-1243.

  15. Barrera Franco JL, Granados García M, Herrera Gómez A, et al. Tratamiento neoadyuvante en el carcinoma epidermoide de cabeza y cuello: experiencia del Instituto Nacional de Cancerología. Rev Inst Nal Cancerol 1998;44:9-14.

  16. Registro Histopatológico de las Neoplasias Malignas. Dirección General de Epidemiología; México: Secretaría de Salud;1999.

  17. Gluckman JL, Crissman JD, Donegan JO. The surgical management of early oral cavity cancers. In: Johnson JT. Didolkar MS, editors. Head and neck cancer. Vol. 3. Amsterdam, The Netherlands: Elsevier Science; 1003:pp.329-331.

  18. Mendenhall WM, Parsons JT, Stringer SP, Million RR. TI-T2 vs cord carcinoma: basis for comparing the results of radiotherapy and surgery. Head Neck Surg 1988;10:373-377.

  19. García OM, Herrera GA, Barrera FJL. Colgajos para la reconstrucción de cabeza y cuello. Experiencia del Instituto Nacional de Cancerología, México. Cir Ciruj 1998;66:172-175.

  20. Rivas B, Ochoa FJ, Murrieta FJ, Barrera JL. Mandibular reconstruction with the free vascularized fibular flap: utility of three-dimensional computerized tomography. J Reconstr Microsurg 1999;15(2):1-7.

  21. Santamaría E, Granados M, Barrera-Franco JL. Radial forearm free tissue transfer for head and neck reconstruction: versatility and reability of a single donor site. Microsurgery 2000;20:195-201.

  22. Gluckman JL. Management of advanced cancer of head and neck. In: Gates G, editor. Current therapy in otolaryngology-head and neck surgery. Vol. 3. Trenton, NJ BC. Decker, Inc. USA; 1986.pp.99-102.

  23. Merlano IT, Corvo R, Margarino G, et al. Combined chemotherapy and radiation therapy in advanced inoperable squamous cell carcinoma of the head and neck. Final report of a randomized trial. Cancer 1991;67:915-917.

  24. O’Brien CJ, Smith JW, Soong SJ, et al. Neck dissection with or without radiotherapy, prognostic factors, pattern of recurrence and survival. Am J Surg 1986;152:456-463.

  25. Merlano LT, Corvo R, Margarino G, et al. Combined chemotherapy and radiation therapy in advanced inoperable squamos cell carcinoma of the head and neck. Final report of a randomized trial. Cancer 1991;67:915-921.

  26. Clark JR, Frei E. Chemotherapy for head and neck cancer: progress and controversy in the management of patients with MO disease. Semin Oncol 1989;16:44-57.

  27. Shah JP, Strong E, Spiro RH, Vikram B. Neck dissection current status and future possibilities. Clin Bufl 1981;11-25.

  28. Jesse RH, Fletcher GH. Treatment of the neck in patients with squamous cell carcinoma of the head and neck. Cancer 1977;39:868-872.

  29. Department of Veterans Affairs Laryngeal Cancer Study Group. Induction chemotherapy plus radiation, compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 1991;324:1685-1690.

  30. Gotay CC, Moore TD. Assessing quality of life in head and neck cancer. Qual Life Res 1992;1:5-17.

  31. Barrera JL, Verástegui E, Zinser J, et al. Combination immunotherapy of squamous cell head and neck cancer. A phase II trial. Arch Otolaryngol Head Neck 2000;126:345-351.

  32. Verástegui E, Barrera-Franco JL, Meneses A, et al. A natural cytokine mixture (NCID) and interference with immune suppression induce mobilization and regression of head and neck cancer. Int J Immunopharmacol 1997;19:619-627.

  33. Thomas DA, Kantatjian HM. Current role of thalidomide in cancer treatment. Curr Opin Oncol 2000;12:564-573.

  34. Patt YZ, Hassa MM, Lozano RD, et al. Phase II trial of thalidomide in the treatment of recurrent or metastasic squamous cell carcinoma of the head and neck (SCHN). Proc Am Soc Clin Oncol 1998;19:471a.

  35. Fine HA, Figg Jaeckle K, et al. Phase II trial of the antiangiogenic agent thalidomide in patients with recurrent high-grade gliomas. J Clin Oncol 2000;8:708-715.

  36. D’mato RJ, Loughnan M, Flynn E, et al. Thalidomide is an inhibitor of the angiogenesis. Proc Natl Acad Sci USA 1994;91:4082-4085.

  37. Haslett PA, Corral LG, Albert M, et al. Thalidomide costimulates primary human T lymphocytes, preferentially inducing proliferation, cytokine production and cytotoxic responses in CD8+ subset. J Exp Med 1998;187:1885-1892.

  38. Hadden JW, Saha A, Sosa M, Hadden EM. Immunotherapy with natural interleukins and/or thymosin alpha 1 potently augments T-lymphocyte responses of hydrocortisone-treated aged mice. Int J Immunopharmacol 1995;17:821-828.

  39. Meneses A, Verástegui E, Barrera JL, et al. Histologic findingss in patients with head and neck squamous cell carcinoma receiving perilymphatic natural cytokine mixture (IRX-2) prior to surgery. Arch Path Lab Lab Med 1998;122:447-454.

  40. Meneses A, Barrera JL, Suárez J, et al. Antiangiogenesis mechanism involved in the clinical responses in patients with squamous cell carcinomas of head and neck treated with IRX-2. A clinical and immunohistological analysis ISBN #88-323-1129-1. In 1st World Congress on Head and Neck Oncology. JJ Alvarez V, editor Monduzzi Ed.; 1998;pp.1155-1158.

  41. Hadden J, Verástegui E, Barrera JL, Kurman M, Zinser JW, Meneses A, de la Garza J, Hadden E. A phase 2 trial in patients with squamous cell carcinoma of the head and neck. INT immunopharmacol (In press).




2020     |     www.medigraphic.com