[Targeting HER pathway in head and neck and thoracic cancers]

Bronchial and head and neck (HN) cancers share similarities especially regarding the HER pathway. Therapeutic progresses targeting the HER pathway are based on monoclonal antibodies, especially cetuximab, and tyrosine kinase (TK) inhibitors, targeting HER only, as gefitinib and erlotinib, or HER and other receptor(s), as VEGFR for the ZD6474. The results obtained already led to the registration of cetuximab (combined with radiotherapy) for management of locally advanced HN cancers, and the registration of erlotinib (and gefitinib in some countries) for management of non-small-cell lung cancer (NSCLC) in the second or third line setting. Therefore, these first successes led to the development of several drugs including monoclonal antibodies (trastuzumab, panitumumab, matuzumab), TK inhibitors targeting one receptor as well as TK pan-inhibitors (lapatinib, HKI 272, PKI 166, EKB-569, AEE-788), currently assessed through clinical trials worldwide. In the same time, progresses regarding the HER pathway also focused on a better selection of patients who clearly beneficiate from these drugs (EGFR gene mutations, EGFR gene amplification by FISH) allowing the first steps in tailoring anticancer treatments in lung cancer. In conclusion, therapeutic progresses targeting the HER pathway have improve management of HN and NSCLC patients and rise hopes for the future.