The dogma of Cetuximab and Radiotherapy in head and neck cancer – A dawn to dusk journey

Impaired DNA double-strand break repair and effective radiosensitization of HPV-negative HNSCC cell lines through combined inhibition of PARP and Wee1

“…Locally advanced HPV- HNSCC have remained a tough to treat tumor entity with currently still unsatisfactory cure rates and an exceptionally high treatment related morbidity from current multimodal regimes. The anti-EGFR antibody cetuximab was believed to be a less toxic and effective alternative to concurrent cisplatin-based chemotherapy but various recent studies in HPV+ and HPV- HNSCC have raised serious concerns regarding both its efficacy and toxicity when combined with radiation [4] , [31] . Large efforts are currently being made to advance immune checkpoint inhibition (ICI) into the curative setting in HNSCC but also here the presently available results of phase III studies of concurrent treatment with ICI and (chemo)radiation have failed to prove efficacy [32] , [33] , [34] .…”

“…Molecular targeting with the aim of tumor radiosensitization may present an alternative to concomitant chemotherapy. The anti-EGFR antibody cetuximab is approved in the curative setting but considerable doubts exist regarding its efficacy when combined with (chemo)radiation [4] .…”

Social, Ethical and Treatment Related Problems Faced by Healthcare Workers in the Care of Head and Neck Cancer Patients: A Narrative Review from the Bioethics Consortium from India

“…However, in the Indian market, the cost of cetuximab amounts to 94,544.4 INR which is onerous even for financially stable families to bear, while for the poor and uninsured patients, this is unimaginable. From financial perspective, when compared to other medical specialties, cancer care is becoming more expensive and professionals should try to keep healthcare costs down while upholding their ethical duty to offer the best care possible for every patient [ 34 – 37 ]. However, the global increase in the national cancer expenditures compels oncologists to look at practise patterns and attempt at reducing the health care cost burden especially for the uninsured patients [ 34 – 37 ].…”

“…From financial perspective, when compared to other medical specialties, cancer care is becoming more expensive and professionals should try to keep healthcare costs down while upholding their ethical duty to offer the best care possible for every patient [ 34 – 37 ]. However, the global increase in the national cancer expenditures compels oncologists to look at practise patterns and attempt at reducing the health care cost burden especially for the uninsured patients [ 34 – 37 ]. This presents severe treatment related ethical dilemma for the treating physicians.…”

Targeted therapy for head and neck cancer: signaling pathways and clinical studies

“… 16 – 19 Early in 2001, the efficacy of cetuximab was investigated in squamous cell carcinomas in vivo, which also enhanced the efficacy of radiotherapy. 20 – 22 Shortly thereafter, cetuximab showed dose-dependent pharmacokinetics, tolerability, and biologic activity when combined with cisplatin in patients with advanced tumors overexpressing EGFR. 23 Further studies indicated that cetuximab is an effective radiation sensitizer, 24 , 25 resulting in the FDA approval of cetuximab plus radiotherapy for the treatment of locally advanced HNSCC (LA-HNSCC) patients in 2006.…”