Radiotherapy, Chemotherapy and Immunotherapy—Current Practice and Future Perspectives for Recurrent/Metastatic Oral Cavity Squamous Cell Carcinoma

Abstract

Oral squamous cell carcinoma is the most common malignant epithelial neoplasm affecting the oral cavity. While surgical resection is the cornerstone of a multimodal curative approach, some tumors are deemed recurrent or metastatic (R/M) and often not suitable for curative surgery. This mainly occurs due to the extent of lesions or when surgery is expected to result in poor functional outcomes. Amongst the main non-surgical therapeutic options for oral squamous cell carcinoma are radiotherapy, chemotherapy, molecular targeted agents, and immunotherapy. Depending on the disease setting, these therapeutic approaches can be used isolated or in combination, with distinct efficacy and side effects. All these factors must be considered for treatment decisions within a multidisciplinary approach. The present article reviews the evidence regarding the treatment of patients with R/M oral squamous cell carcinoma. The main goal is to provide an overview of available treatment options and address future therapeutic perspectives.

First‑line programmed cell death 1 inhibitor plus chemotherapy vs. standard treatment in patients with recurrent or metastatic oral squamous cell carcinoma: A retrospective cohort study

“…However, the ORR (52.4 vs. 36.7%) and DCR (81.0 vs. 70.0%) were numerically elevated in patients with R/M OSCC treated with PD-1 inhibitor + chemotherapy compared with those receiving standard treatment. The potential explanations may be as follows: PD-1 inhibitor was assumed to potentiate the cytotoxic effect of chemotherapy on tumor cells by altering the tumor microenvironment (29)(30)(31), and to facilitate death of tumor cells through reviving the cytotoxic activity of T lymphocytes (32). Therefore, PD-1 inhibitor + chemotherapy achieved a numerically higher ORR and DCR in patients with R/M OSCC compared with those on standard treatment; however, the findings require ------------------------------------------------------------------------------------------------------------------------------------------------------------- further validation in large-scale studies.…”

Matrix‐based molecular mechanisms, targeting and diagnostics in oral squamous cell carcinoma

“…113 Chemotherapy could inhibit rapidly growing cells, even in metastatic areas, by inhibiting cell growth and division, while monoclonal antibodies and immune checkpoint inhibitors are very promising new therapeutic methods. 114 Another promising treatment approach may involve inhibiting ECM elements that support tumor progression and metastasis. 115 Through its regulatory control, the ECM influences not only the tumor's development, but also its response to therapy.…”

“…Surgery with radiotherapy, have difficulty in dealing with metastatic tumors 113 . Chemotherapy could inhibit rapidly growing cells, even in metastatic areas, by inhibiting cell growth and division, while monoclonal antibodies and immune checkpoint inhibitors are very promising new therapeutic methods 114 . Another promising treatment approach may involve inhibiting ECM elements that support tumor progression and metastasis 115 .…”