Carcinoma de células escamosas de la cabeza y el cuello (HNSCC)
Vista determinista de la entidad fuente YAML. La autoridad clínica sigue con los ID de fuente citados y estado de firma del revisor.
| ID | DIS-HNSCC |
|---|---|
| Tipo | Enfermedad |
| Aliaces | HNSCCCarcinoma de células escamosas de la cabeza y el cuelloSCCHNПлоскоклітинна карцинома голови та шиї |
| Situación | reviewed 2026-04-27 | pending_clinical_signoff |
| Enfermedades | Ninguna declarada |
| Fuentes | SRC-NCCN-NSCLC-2025 |
Informational support. All recommendations must be verified by a qualified oncologist. Engineering checks are not clinical validation or treatment approval.
| icd_o_3_morphology | 8070/3 |
|---|---|
| icd_o_3_topography | ["C00", "C01", "C02", "C03", "C04", "C05", "C06", "C07", "C08", "C09", "C10", "C11", "C12", "C13", "C14", "C30", "C31", "C32"] |
| icd_10 | C00-C14, C30-C32 |
| who_classification | WHO Head and Neck Tumours 5th ed (2024): Squamous cell carcinoma of upper aerodigestive tract |
Notas
Two distinct biologies under one disease entity: HPV+ oropharyngeal: typically tonsil / base of tongue; younger patients; better prognosis; AJCC 8 separate staging system; active de-escalation trials (cisplatin-light or radiation-light protocols). HPV− (tobacco / alcohol): higher TP53 / CDKN2A mutation burden; worse prognosis; standard intensification. Therapy: - Localized: surgery (oral cavity preferred when feasible) ± adjuvant chemoRT; or concurrent cisplatin-RT (definitive); or induction + chemoRT (selected hypopharynx / larynx preservation). - Recurrent / metastatic 1L: * PD-L1 CPS ≥20: pembrolizumab monotherapy (KEYNOTE-048). * PD-L1 CPS ≥1: pembrolizumab + 5-FU + platinum (KEYNOTE-048 chemo-IO). * EXTREME (cetuximab + 5-FU + platinum) remains alternative. - 2L+: nivolumab (CheckMate-141) if IO-naive; cetuximab monotherapy / methotrexate / docetaxel. - Genotype-driven (investigational / accelerated): * HRAS mutant (~6-8%): tipifarnib (FDA breakthrough designation; AIM-HN phase 3 ongoing). * NTRK fusion (rare): larotrectinib / entrectinib. * BRAF V600E (very rare): dabrafenib + trametinib. Cetuximab (anti-EGFR mAb) has activity irrespective of EGFR mutational status — small-m...
Utilizado por
Relevancia terapéutica
BMA-PDL1-CPS-HNSCC- PD-L1 CPS es el biomarcador predictivo primario para pembrolizumab en H recurrente/metastásico...
Algoritmos
ALGO-HNSCC-RM-1L- ALGO-HNSCC-RM-1LALGO-HNSCC-RM-2L- ALGO-HNSCC-RM-2LALGO-LARYNGEAL-1L- ALGO-LARYNGEAL-1L
Enfermedad
DIS-BCC- Carcinoma de células basales (BCC)DIS-LARYNGEAL- Carcinoma de células escamosas laríngeasDIS-NPC- Carcinoma nasofaríngeo (NPC)DIS-SALIVARY- Carcinoma de la glándula saliva
Indicación
IND-HNSCC-RM-1L-EXTREME- IND-HNSCC-RM-1L-EXTREMEIND-HNSCC-RM-1L-PEMBRO-CHEMO- IND-HNSCC-RM-1L-PEMBRO-CHEMOIND-HNSCC-RM-1L-PEMBRO-MONO-CPS-HIGH- IND-HNSCC-RM-1L-PEMBRO-MONO-CPS-HIGHIND-HNSCC-RM-2L-NIVOLUMAB- IND-HNSCC-RM-2L-NIVOLUMABIND-HNSCC-RM-2L-PEMBROLIZUMAB- IND-HNSCC-RM-2L-PEMBROLIZUMABIND-LARYNGEAL-RM-1L-PEMBRO-CHEMO- IND-LARYNGEAL-RM-1L-PEMBRO-CHEMOIND-LIFESTYLE-SMOKELESS-TOBACCO-PREVENTION-OBSERVATION- IND-LIFESTYLE-SMOKELESS-TOBACCO-PREVENTION-OBSERVATIONIND-LIFESTYLE-SMOKELESS-TOBACCO-PREVENTION-SURVEILLANCE- IND-LIFESTYLE-SMOKELESS-TOBACCO-PREVENTION-SURVEILLANCEIND-OCC-WOOD-LEATHER-DUST-PREVENTION-INTENSIFIED-SURVEILLANCE- IND-OCC-WOOD-LEATHER-DUST-PREVENTION-INTENSIFIED-SURVEILLANCEIND-OCC-WOOD-LEATHER-DUST-PREVENTION-OBSERVATION- IND-OCC-WOOD-LEATHER-DUST-PREVENTION-OBSERVATION
Cuestionarios
QUEST-HNSCC-1L-STUB- Carcinoma de células escamosas de cabeza y cuello — primera línea
Señal de alerta
RF-ACTIVE-AUTOIMMUNE-DISEASE-ICI-RISK- Paciente con pre-inmunes o inflamatorias preexistentes activas o incompletas...RF-HNSCC-FRAILTY-AGE- Edad ≥75 con ECOG ≥2, ≥2 comorbidades, pérdida de peso >5%, o albúmina <3,5 g/dL — con...RF-HNSCC-HIGH-RISK-BIOLOGY- Biología adversa en la CSC de cabeza y cuello: enfermedad orofaríngea negativa al VPH, p16 negativa, s...RF-HNSCC-INFECTION-SCREENING- Active or latent infection requiring resolution / prophylaxis before initiating cisplatin...RF-HNSCC-ORGAN-DYSFUNCTION- Baseline organ dysfunction precluding standard cisplatin-based chemoradiation or pembroli...RF-HNSCC-TRANSFORMATION-PROGRESSION- Recurrencia loco-regional dentro de 6 meses de quimioterapia definitiva, nuevo metástago distante...RF-LIFESTYLE-SMOKELESS-TOBACCO-PREVENTION- Habitual use of smokeless tobacco products — chewing tobacco, snus (oral nicotine pouch w...RF-OCC-FORMALDEHYDE-PREVENTION- Exposición laboral histórica documentada al formaldehído (HCHO gaseoso y acuoso para...RF-OCC-WOOD-LEATHER-DUST-PREVENTION- Exposición laboral histórica documentada al polvo de madera dura (haya, fayo, caoba, valnu...
Fuentes
SRC-EXTREME-VERMORKEN-2008- Quimioterapia a base de platino más cetuximab en cáncer de cabeza y cuelloSRC-KEYNOTE-048-BURTNESS-2019- Pembrolizumab solo o con quimioterapia versus cetuximab con quimioterapia para...SRC-NCCN-HNSCC-2025- Directrices de Práctica Clínica NCCN - Cánceres de cabeza y cuello