Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma in Older Patients: Are New Agents Bringing New Hope?
Maria Cossu RoccaLuigi LoriniPetr SzturzPaolo BossiJan B VermorkenPublished in: Drugs & aging (2023)
Head and neck cancer is a broad family of diseases, most of which are of squamous cell origin, affecting the epithelial mucosa lining the upper aerodigestive tract. They often recur or are progressive despite multimodality treatment approaches, resulting in a poor prognosis. Given the progressive aging of the global population, the probability to plan an active and eventually toxic treatment for an older patient, with either curative or palliative intent, can no longer be considered as an uncommon occurrence. A crucial point in offering a systemic treatment to older patients with head and neck squamous cell carcinoma is that they are underrepresented in randomised clinical trials, and evidence-based guidelines are lacking, while, from a clinical point of view, these patients may have varying grades of resilience to anticancer treatments due to differences in their health, social and/or economic status. Our aim is to draw attention to the older patient population suffering from recurrent and/or metastatic head and neck squamous cell carcinoma and to address some open questions, such as possible differences in epidemiology and biology compared with their younger counterparts; to highlight frailty and its components by discussing how to measure and use it to personalise treatment; to evaluate which outcomes should be best achieved in the older adult setting; finally, in the era of immunotherapy, to examine whether there are differences to be addressed when considering new treatments for older patients.
Keyphrases
- poor prognosis
- clinical trial
- squamous cell carcinoma
- small cell lung cancer
- community dwelling
- mental health
- multiple sclerosis
- public health
- healthcare
- risk assessment
- long non coding rna
- palliative care
- climate change
- risk factors
- ejection fraction
- depressive symptoms
- type diabetes
- insulin resistance
- young adults
- health information
- social media
- smoking cessation
- study protocol
- clinical practice
- patient reported outcomes
- health promotion
- childhood cancer
- advanced cancer