Optimizing systemic therapy in squamous cell carcinoma of the head and neck with a focus on targeted agents

Squamous cell carcinoma of head and neck (SCCHN) is the most common neoplasm in the upper aerodigestive tract. In this review, we attempt to summarize the major advances of the last few years with a focus on the use of systemic therapy alone for recurrent or metastatic disease, or in combination with radiation and surgery for locally advanced disease. In 2000, a large meta-analysis concluded that the addition of systemic therapy to radiotherapy was superior to radiotherapy alone in improving outcome for patients with SCCHN. Since then, several clinical trials have established concurrent chemotherapy and radiation as the new standard of care in treatment of locally advanced disease.

Over the last two decades, new concepts have emerged introducing the novel sequencing of systemic and radiation therapy such as the use of induction chemotherapy and sequential chemotherapy and radiation therapy. Novel targeted agents, including the epidermal growth factor receptor antibody cetuximab, have been approved for use as single agents or in combination with radiation therapy or chemotherapy in treatment of recurrent metastatic disease.

This review aims to condense the most recent advances in SCCHN treatment, focusing on the practice-changing outcomes of pivotal studies namely the use of novel targeted agents.