Vol 6, No 5 (2010)
Review paper
Published online: 2011-01-19

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Anti-EGFR targeted therapy for squamos cell head and neck cancer

Andrzej Kawecki
Onkol. Prak. Klin 2010;6(5):264-271.

Abstract

Standards of radical treatment for squamous cell head and neck cancer (SCHNC) were changed during last decade. Concomitant radiochemiotherapy became a treatment of choice for locally advanced SCHNC. This method in comparison with radiotherapy alone produces significant benefit in overall survival. However, concomitant radiochemotherapy carries high risk of early and late toxicity. This method is beneficial for a limited subgroup of patients. In this situation, investigation of new therapeutic strategies is necessary. Currently, probably the most attractive radical treatment strategy is targeted therapy combined with traditional methods like radiotherapy or radiochemotherapy. Similarly, targeted therapy is the most promising method of treatment for recurrent or metastatic SCHNC. The most recognized and well investigated target of molecular treatment for SCHNC is epidermal growth factor receptor (EGFR). EGFR signaling pathway activation is associated with tumor progression and stimulation of chemo- and radioresistance. EGFR expression is observed in nearly 100% of SCHNC. The most investigated in advanced clinical trials inhibitor of the EGFR is cetuximab a monoclonal antibody. Randomized phase III clinical trial showed that addition of cetuximab to radiation therapy improves survival in patients with locally advanced SCHNC without escalation of radiation-related toxicity. Recently another randomized trial showed that combination of cetuximab with traditional chemotherapy improves overall survival in patients with recurrent or metastatic SCHNC. Many others targeted therapy strategies and drugs are now under investigations. In this paper current indications, limitations and perspectives of the anti-EGFR targeted therapy for SCHNC are discussed.

Onkol. Prak. Klin. 2010; 6, 5: 264–271

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