Bleeding complications in patients with squamous cell carcinoma of the head and neck.
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Hemorrhage in recurrent and/or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) may be attributed to chemotherapy and local tumor irradiation. Evidence of the relationship between hemorrhage in R/M HNSCC and targeted therapies, including epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) inhibitors, or immune checkpoint inhibitors, is limited. We aimed to identify epidemiological and clinical data related to the occurrence of hemorrhage in R/M HNSCC and to explore its relationship with various therapies. We describe information obtained from literature searches as well as data extracted from a commercial database and a database from the author's institution (Istituto Nazionale dei Tumori of Milan). Evidence suggests that most bleeding events in R/M HNSCC are minor. Clinical trial safety data do not identify a causal association between hemorrhage and anti-EGFR agents or immune checkpoint inhibitors. In contrast, anti-VEGF agents are associated with increased, and often severe/fatal, hemorrhagic complications.
head and neck squamous cell carcinoma
immune checkpoint inhibitors
molecular targeted therapies
Carcinoma, Squamous Cell
Head and Neck Neoplasms
Neoplasm Recurrence, Local
Squamous Cell Carcinoma of Head and Neck
Vascular Endothelial Growth Factor A
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Head and Neck: journal for the sciences and specialities of the head and neck, 2021, 43 (9), pp. 2844 - 2858