The molecular initiators of Head and Heck Squamous Cell Carcinoma (HNSCC) are complex. Human Papillomavirus (HPV) infection is linked to an increasing number of HNSCC cases, but HPV-positive tumors generally have a good prognosis. External factors that promote the development of HPV-negative HNSCC include tobacco use, excessive alcohol consumption, and proinflammatory poor oral hygiene. On a molecular level, several events, including the well-known overexpression of epidermal growth factor receptors (EGFR) and related downstream signaling pathways, contribute to the development of HNSCC. Conventional chemotherapy is insufficient for many patients. Thus, molecular-based therapy for HNSCC offers patients a better chance at a cure. The first molecular target for therapy of HNSCC was EGFR, inhibited by monoclonal antibody cetuximab, but its use in monotherapy is insufficient and induces resistance. This article describes attempts at combinatorial molecular targeted therapy of HNSCC based on several molecular targets and exemplary drugs/drug candidates. The new concept of anakoinosis-based therapy, which means treatment that targets the intercellular and intracellular communication of cancer cells, is thought to be the way to improve the clinical outcome for HNSCC patients. The identification of a link between molecular targeted therapy and anakoinosis raises the potential for further progress in HPV-negative HNSCC therapy.
头颈部鳞状细胞癌（HNSCC）的分子起始机制十分复杂。人乳头瘤病毒（HPV）感染与日益增多的HNSCC病例相关，但HPV阳性肿瘤通常预后良好。促进HPV阴性HNSCC发生的外部因素包括吸烟、过量饮酒以及具有促炎作用的口腔卫生不良。在分子水平上，多种分子事件共同推动HNSCC的发展，其中表皮生长因子受体（EGFR）及其相关下游信号通路的过度表达是典型代表。传统化疗对许多患者疗效有限，因此基于分子靶向的HNSCC治疗为患者提供了更好的治愈机会。首个HNSCC治疗的分子靶点是EGFR，可通过单克隆抗体西妥昔单抗进行抑制，但单药治疗不仅效果有限还会诱发耐药性。本文阐述了基于多个分子靶点及代表性药物/候选药物的HNSCC联合分子靶向治疗尝试。基于"anakoinosis"（意指靶向癌细胞间及细胞内通讯的治疗方式）的新型治疗理念，被认为是改善HNSCC患者临床预后的重要方向。分子靶向治疗与anakoinosis之间关联的发现，为HPV阴性HNSCC治疗的进一步发展提供了潜在可能。
肿瘤(癌症)患者之家