International Journal of Hematology and Oncology 2020, Vol 30, Num 2 Page(s): 046-056
Targeted Therapy in Head and Neck Cancer

İlhan ÖZTOP

Dokuz Eylül Üniversitesi Onkoloji Enstitüsü, İZMİR

Keywords: Head and neck cancer, Targeted therapy
Squamous cell head and neck cancer (SCCHN) is the seventh most common cause of cancer death worldwide and its incidence is rising rapidly in developing countries. For patients with early and locally advanced stage disease, significant advances have been made in the treatment of SCCHN. For patients at high risk of local recurrence and those with locally advanced disease, concurrent chemoradiotherapy after surgical resection has been shown to significantly improve local disease control and overall survival. Despite recent advances in the management of locally advanced SCCHN, patients with recurrent and metastatic SCCHN have a poor prognosis and little progress has been made for the management. Furthermore aggressive therapy is at a price of severe acute and chronic morbidity. Epidermal growth factor receptor (EGFR) has been implicated in the pathogenesis of SCCHN and is a marker of poor prognosis. Recent advances in targeted therapeutics against EGFR are being investigated clinically. In this article, we reviewed the different modalities utilized to inhibit EGFR signaling in SCCHN, including small molecule tyrosine kinase inhibitors and monoclonal antibodies. Monotherapy with EGFR inhibitors has demonstrated response rates between 5 and 15% in advanced SCCHN. However, combining EGFR inhibitors with cytotoxic chemotherapy or radiation therapy appears to augment response rates and survival. Another factor that have a role in the pathogenesis of SCCHN is vascular endothelial growth factor (VEGF) and anti-angiogenic approaches with anti-VEGF antibodies have also show some promise. Perhaps in the future we will see trials incorporating different targeted strategies in the treatment of SCCHN.