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      FGFR-gerichtete Therapie von Kopf-Hals-Karzinomen Translated title: FGFR-targeted therapy in head and neck carcinomas

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          Abstract

          Hintergrund

          Genomische Veränderungen (Mutationen, Genfusionen, Amplifikationen) und eine Dysregulierung des Fibroblasten-Wachstumsfaktor-Rezeptor-Signalwegs („fibroblast growth factor (FGF) receptor“, FGFR) sind häufig in Plattenepithelkarzinomen des Kopf-Hals-Bereichs (HNSCC) zu finden. Eine zielgerichtete Therapie mit gegen FGF-Rezeptoren gerichteten Tyrosinkinaseinhibitoren (TKI) oder monoklonalen Antikörpern stellt daher einen vielversprechenden Ansatz für die Behandlung des HNSCC dar.

          Fragestellung

          Dieser Übersichtsartikel beschreibt den aktuellen Wissensstand hinsichtlich FGFR-gerichteter Therapien bei Kopf-Hals-Tumoren (insbesondere HNSCC) und diskutiert in diesem Kontext genomische Veränderungen des FGFR-Signalwegs als potenzielle begleitende prädiktive Biomarker.

          Material und Methode

          Der vorliegende Artikel basiert auf einer Recherche der Datenbanken PubMed, ClinicalTrials.gov sowie von Tagungsbänden.

          Ergebnisse

          Erste Ergebnisse belegen die Wirksamkeit von Tyrosinkinase-Inhibitoren sowohl bei HNSCC als auch bei Adenokarzinomen des Kopf-Hals-Bereichs, insbesondere bei Schilddrüsenkarzinomen und adenoid-zystischen Speicheldrüsenkarzinomen.

          Schlussfolgerungen

          Frühe klinische und präklinische Daten verdeutlichen das Potenzial einer biomarkergesteuerten Behandlung von Patienten mit Kopf-Hals-Tumoren mit gegen FGFR-gerichtete TKI.

          Translated abstract

          Background

          Genomic aberrations (mutations, gene fusions, amplifications) and dysregulation of the fibroblast growth factor (FGF) receptor (FGFR) signaling pathway are frequently found in squamous cell carcinomas of the head and neck (HNSCCs). Targeted therapy with tyrosine kinase inhibitors (TKIs) or monoclonal antibodies directed against FGF receptors therefore represents a promising approach for the treatment of HNSCC.

          Objective

          This review article describes the current status of FGFR-directed therapies for head and neck tumors (especially HNSCC) and, in this context, discusses genomic alterations of the FGFR pathway as potential companion predictive biomarkers.

          Methods

          This article is based on searches of PubMed, ClinicalTrials.gov, and conference proceedings.

          Results

          First results prove the efficacy of TKIs both in HNSCC and in adenocarcinomas of the head and neck, especially in thyroid and adenocystic salivary gland carcinomas.

          Conclusion

          Early clinical and preclinical data point to the promise of biomarker-directed treatment of patients with head and neck tumors using FGFR-targeted TKIs.

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          Most cited references83

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          Hallmarks of Cancer: The Next Generation

          The hallmarks of cancer comprise six biological capabilities acquired during the multistep development of human tumors. The hallmarks constitute an organizing principle for rationalizing the complexities of neoplastic disease. They include sustaining proliferative signaling, evading growth suppressors, resisting cell death, enabling replicative immortality, inducing angiogenesis, and activating invasion and metastasis. Underlying these hallmarks are genome instability, which generates the genetic diversity that expedites their acquisition, and inflammation, which fosters multiple hallmark functions. Conceptual progress in the last decade has added two emerging hallmarks of potential generality to this list-reprogramming of energy metabolism and evading immune destruction. In addition to cancer cells, tumors exhibit another dimension of complexity: they contain a repertoire of recruited, ostensibly normal cells that contribute to the acquisition of hallmark traits by creating the "tumor microenvironment." Recognition of the widespread applicability of these concepts will increasingly affect the development of new means to treat human cancer. Copyright © 2011 Elsevier Inc. All rights reserved.
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            Patterns of somatic mutation in human cancer genomes.

            Cancers arise owing to mutations in a subset of genes that confer growth advantage. The availability of the human genome sequence led us to propose that systematic resequencing of cancer genomes for mutations would lead to the discovery of many additional cancer genes. Here we report more than 1,000 somatic mutations found in 274 megabases (Mb) of DNA corresponding to the coding exons of 518 protein kinase genes in 210 diverse human cancers. There was substantial variation in the number and pattern of mutations in individual cancers reflecting different exposures, DNA repair defects and cellular origins. Most somatic mutations are likely to be 'passengers' that do not contribute to oncogenesis. However, there was evidence for 'driver' mutations contributing to the development of the cancers studied in approximately 120 genes. Systematic sequencing of cancer genomes therefore reveals the evolutionary diversity of cancers and implicates a larger repertoire of cancer genes than previously anticipated.
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              Comprehensive genomic characterization of head and neck squamous cell carcinomas

              The Cancer Genome Atlas profiled 279 head and neck squamous cell carcinomas (HNSCCs) to provide a comprehensive landscape of somatic genomic alterations. We find that human papillomavirus-associated (HPV) tumors are dominated by helicase domain mutations of the oncogene PIK3CA, novel alterations involving loss of TRAF3, and amplification of the cell cycle gene E2F1. Smoking-related HNSCCs demonstrate near universal loss of TP53 mutations and CDKN2A with frequent copy number alterations including a novel amplification of 11q22. A subgroup of oral cavity tumors with favorable clinical outcomes displayed infrequent CNAs in conjunction with activating mutations of HRAS or PIK3CA, coupled with inactivating mutations of CASP8, NOTCH1 and wild-type TP53. Other distinct subgroups harbored novel loss of function alterations of the chromatin modifier NSD1, Wnt pathway genes AJUBA and FAT1, and activation of oxidative stress factor NFE2L2, mainly in laryngeal tumors. Therapeutic candidate alterations were identified in the majority of HNSCC's.
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                Author and article information

                Contributors
                dimo.dietrich@gmail.com
                Journal
                HNO
                HNO
                Hno
                Springer Medizin (Heidelberg )
                0017-6192
                1433-0458
                9 June 2020
                9 June 2020
                2021
                : 69
                : 3
                : 172-184
                Affiliations
                GRID grid.15090.3d, ISNI 0000 0000 8786 803X, Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde/Chirurgie, , Universitätsklinikum Bonn, ; Venusberg-Campus 1, 53127 Bonn, Deutschland
                Article
                893
                10.1007/s00106-020-00893-2
                7902560
                32519203
                af4fd94e-d0cc-4b07-9545-f54e104d7723
                © The Author(s) 2020

                Open Access. Dieser Artikel wird unter der Creative Commons Namensnennung 4.0 International Lizenz veröffentlicht, welche die Nutzung, Vervielfältigung, Bearbeitung, Verbreitung und Wiedergabe in jeglichem Medium und Format erlaubt, sofern Sie den/die ursprünglichen Autor(en) und die Quelle ordnungsgemäß nennen, einen Link zur Creative Commons Lizenz beifügen und angeben, ob Änderungen vorgenommen wurden.

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                History
                Funding
                Funded by: Universitätsklinikum Bonn (8930)
                Categories
                Übersichten
                Custom metadata
                © Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2021

                fibroblasten-wachstumsfaktor-rezeptor,tyrosinkinaseinhibitor,plattenepithelkarzinom des kopf-hals-bereichs,prädiktiver biomarker,mutation,fibroblast growth factor receptor,tyrosine kinase inhibitor,head and neck squamous cell carcinoma,predictive biomarker

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