Epidermal Growth Factor Receptor Targeted Therapy in Stages III and IV Head and Neck Cancer

Abstract

Chemoradiation is the current standard of care for patients with locally advanced HNSCC, and to date, there is no evidence that compares cetuximab plus radiotherapy with chemoradiation, or that examines whether the addition of cetuximab to chemoradiation is of benefit in these patients. However, five ongoing trials are investigating the effect of the addition of EGFR inhibitors concurrently with, before, or after chemoradiotherapy; those trials should provide direction about the best integration of cetuximab into standard treatment. In patients with recurrent or metastatic HNSCC who experience progressive disease despite, or who are unsuitable for, first-line platinum-based chemotherapy, gefitinib at doses of 250 mg or 500 mg daily, compared with weekly methotrexate, did not increase median overall survival [hazard ratio (hr): 1.22; 96% confidence interval (ci): 0.95 to 1.57; p = 0.12 (for 250 mg daily vs. weekly methotrexate); hr: 1.12; 95% ci: 0.87 to 1.43; p = 0.39 (for 500 mg daily vs. weekly methotrexate)] or objective response rate (2.7% for 250 mg and 7.6% for 500 mg daily vs. 3.9% for weekly methotrexate, p > 0.05). As compared with methotrexate, gefitinib was associated with an increased incidence of tumour hemorrhage (8.9% for 250 mg and 11.4% for 500 mg daily vs. 1.9% for weekly methotrexate).

Quantum dot-based quantitative immunofluorescence detection and spectrum analysis of epidermal growth factor receptor in breast cancer tissue arrays

“…EGFR has been studied from different perspectives and has been considered as a new therapeutic target in solid tumors. Cetuximab, gefitinib, erlotinib, and lapatinib [17][18][19][20][21][22] are agents targeting the EGFR pathway, and have been approved for the treatment of advanced colorectal cancer, squamous cell carcinoma of the head and neck, advanced non-small cell lung cancer, pancreatic cancer, and breast cancer, 23 which has led investigators to restudy EGFR from different perspectives. 24 In the ErbB family, HER2 is the most extensively studied member, and its overexpression is closely correlated with aggressive behavior and poor prognosis of breast cancer.…”

Oropharyngeal cancer: an emergent disease?

“…72 Therefore, cetuximabradiotherapy might be an option among patients over 70 or those unfit for chemotherapy and radiotherapy. 73 …”

Cell Signalings and the Communications in Head and Neck Cancer

“…HNSCC (head and neck squamous cell carcinoma) is the sixth most common neoplasm worldwide (Cripps et al, 2010). Approximately 600,000 new cases are reported each year (Cripps et al, 2010), and in the past 30 years recurrent and/ or metastatic HNSCC has had a poor prognosis (Forastiere et al, 2001;Khuri et al, 2000).…”

“…Approximately 600,000 new cases are reported each year (Cripps et al, 2010), and in the past 30 years recurrent and/ or metastatic HNSCC has had a poor prognosis (Forastiere et al, 2001;Khuri et al, 2000). More than 50% of newly diagnosed patients do not achieve complete remission, and in approximately 10% of HNSCC cases relapse with metastasis to distant organs has been reported (van Houten et al, 2000).…”