University of Oulu

Hyytiäinen A, Wahbi W, Väyrynen O, Saarilahti K, Karihtala P, Salo T and Al-Samadi A (2021) Angiogenesis Inhibitors for Head and Neck Squamous Cell Carcinoma Treatment: Is There Still Hope? Front. Oncol. 11:683570. doi: 10.3389/fonc.2021.683570

Angiogenesis inhibitors for head and neck squamous cell carcinoma treatment : is there still hope?

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Author: Hyytiäinen, Aini1,2; Wahbi, Wafa1,2; Väyrynen, Otto1;
Organizations: 1Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, Helsinki, Finland
2Translational Immunology Programme, Faculty of Medicine, University of Helsinki, Helsinki, Finland
3Department of Oncology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
4Department of Oncology, Helsinki University Hospital Comprehensive Cancer Centre and University of Helsinki, Helsinki, Finland
5Department of Pathology, University of Helsinki, Helsinki, Finland
6Cancer Research and Translational Medicine Research Unit, University of Oulu, Oulu, Finland
7Oulu Medical Research Centre, Oulu University Hospital, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1 MB)
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Language: English
Published: Frontiers Media, 2021
Publish Date: 2021-10-11


Background: Head and neck squamous cell carcinoma (HNSCC) carries poor survival outcomes despite recent progress in cancer treatment in general. Angiogenesis is crucial for tumour survival and progression. Therefore, several agents targeting the pathways that mediate angiogenesis have been developed. We conducted a systematic review to summarise the current clinical trial data examining angiogenesis inhibitors in HNSCC.

Methods: We carried out a literature search on three angiogenesis inhibitor categories—bevacizumab, tyrosine kinase inhibitors and endostatin—from Ovid MEDLINE, Cochrane Library, Scopus and database.

Results: Here, we analysed 38 clinical trials, total of 1670 patients, investigating 12 angiogenesis inhibitors. All trials were in phase I or II, except one study in phase III on bevacizumab. Angiogenesis inhibitors were used as mono- and combination therapies together with radio-, chemo-, targeted- or immunotherapy. Among 12 angiogenesis inhibitors, bevacizumab was the most studied drug, included in 13 trials. Although bevacizumab appeared effective in various combinations, it associated with high toxicity levels. Endostatin and lenvatinib were well-tolerated and their anticancer effects appeared promising.

Conclusions: Most studies did not show benefit of angiogenesis inhibitors in HNSCC treatment. Additionally, angiogenesis inhibitors were associated with considerable toxicity. However, some results appear encouraging, suggesting that further investigations of angiogenesis inhibitors, particularly in combination therapies, for HNSCC patients are warranted.

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Series: Frontiers in oncology
ISSN: 2234-943X
ISSN-E: 2234-943X
ISSN-L: 2234-943X
Volume: 11
Article number: 683570
DOI: 10.3389/fonc.2021.683570
Type of Publication: A2 Review article in a scientific journal
Field of Science: 3122 Cancers
Funding: The authors gratefully acknowledge the following funders of this study: the Sigrid Jusélius Foundation, the Cancer Society of Finland, the Oulu University Hospital MRC grant, Helsinki University Central Hospital research funds, the Jane and Aatos Erkko Foundation, and the Medicinska Understödsföreningen Liv och Hälsa Foundation.
Copyright information: © 2021 Hyytiäinen, Wahbi, Väyrynen, Saarilahti, Karihtala, Salo and Al-Samadi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.