Recent advances of novel targeted therapy for squamous cell carcinoma of the head and neck

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Recent advances of novel targeted therapy for squamous cell carcinoma of the head and neck Jed A. Katzel Æ Michael P. Fanucchi Æ William A. Cook Æ Zujun Li

Received: 2 June 2009 / Accepted: 12 August 2009 / Published online: 12 September 2009 Ó Springer-Verlag 2009

Abstract Targeted therapies have proven beneficial for patients suffering from a number of different malignancies, including cancers of the head and neck. Cetuximab, a monoclonal antibody targeting the epidermal growth factor receptor has shown benefit in combination with radiation for untreated patients or as a single agent for patients with platinum resistant disease. Cetuximab is the only targeted agent currently approved by the Federal Drug Administration for the treatment of head and neck cancer. A number of other agents have shown promising initial results including intracellular tyrosine kinase inhibitors, agents targeting vascular endothelial growth factor receptor, as well as other classes of novel therapies. Some of the data supporting the use of targeted therapy, including agents not yet approved in head and neck cancer, will be presented in this review. As our understanding of the cancer cell signaling pathways and novel targeted agents increases, the potential for treatment with reduced toxicity and improved clinical outcomes will become a reality. Keywords Epidermal growth factor receptor  Cetuximab  Vascular endothelial growth factor receptor  Head and neck cancer  Targeted therapy

J. A. Katzel  M. P. Fanucchi  W. A. Cook  Z. Li (&) Department of Hematology and Oncology, Saint Vincent’s Hospital, Manhattan, USA e-mail: [email protected] J. A. Katzel  M. P. Fanucchi  W. A. Cook  Z. Li New York Medical College, Valhalla, NY, USA J. A. Katzel  M. P. Fanucchi  W. A. Cook  Z. Li Saint Vincent’s Comprehensive Cancer Center, 325 West 15th Street, New York, NY 10011, USA

Introduction Head and neck cancers account for significant morbidity and mortality. It is the fifth most common cancer worldwide, and the most common neoplasm in central Asia. In 2002 for example, head and neck cancer was responsible for approximately 261,784 deaths. Of these, 70% occurred in men [1]. Likewise, in USA there were an estimated 35,310 new cases of oral cavity and pharynx cavity cancer in 2008, and 7,590 estimated deaths [2]. Among all patients diagnosed with head and neck cancer between 1996 and 2003 the relative 5-year survival rate was approximately 60%. This is only a slight improvement when compared with patients who were diagnosed from 1975 to 1977, in whom the 5-year survival rate was approximately 53% [2]. Squamous cell histology accounts for 90–95% of all head and neck carcinomas. Other histological types include: adenocarcinoma, adenoid cystic carcinomas, and mucoepidermoid carcinoma. Most trials involving targeted therapies in head and neck cancer have evaluated patients with squamous cell histology. Some of the exciting new agents targeting squamous cell carcinoma of the head and neck (HNSCC) will be highlighted here.

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