Abstract
Targeting of the EGF receptor (EGFR) has become a standard of care in several tumor types. In squamous cell carcinoma of the head and neck, monoclonal antibodies directed against EGFR have become a regular component of therapy for curative as well as palliative treatment strategies. These agents have anti-tumor efficacy as a single modality and have demonstrated synergistic tumor killing when combined with radiation and/or chemotherapy. While cetuximab has been the primary anti-EGFR monoclonal antibody used in the US, variant anti-EGFR monoclonal antibodies have been used in several clinical studies and shown benefit with improved toxicity profiles. Next generation anti-EGFR monoclonal antibodies may demonstrate multi-target epitope recognition, enhanced immune cell stimulation, or conjugation with radioisotopes in order to improve clinical outcomes. Identification of the specific patient subset that would optimally benefit from anti-EGFR monoclonal antibodies remains an elusive goal.
Highlights
In 2012, head and neck cancers of the oral cavity and pharynx will make up an estimated 2.5% of cancer diagnoses in the United States and for the 40,250 new cases diagnosed, there will be an estimated 7,850 deaths [1]
Molecular analysis of SCCHN has found the overexpression of the epidermal growth factor receptor (EGFR) at rates of up to 90% in tumors and EGFR overexpression has been associated with a poor prognosis [6,7,8,9,10,11]
Zhang et al combined cetuximab and radiation therapy with the addition of cisplatin chemotherapy which resulted in the decreased survival of several human head and neck cancer cell lines [53]
Summary
In 2012, head and neck cancers of the oral cavity and pharynx will make up an estimated 2.5% of cancer diagnoses in the United States and for the 40,250 new cases diagnosed, there will be an estimated 7,850 deaths [1]. Local recurrence rates of 30–50% and distant metastasis rates of 13–22% illustrate the need for more effective therapies [4, 5]. Towards this end, molecular analysis of SCCHN has found the overexpression of the epidermal growth factor receptor (EGFR) at rates of up to 90% in tumors and EGFR overexpression has been associated with a poor prognosis [6,7,8,9,10,11]. We aim to discuss treatment responses that have been enhanced with anti-EGFR monoclonal antibody therapy in combination with chemotherapy and/or radiation therapy. We will discuss novel approaches under development to improve the antitumor properties of EGFR directed monoclonal antibodies
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