Docetaxel in the management of head and neck cancer

Squamous cell carcinoma of the head and neck is a major health problem, and much effort is being made in the different settings of its presentation. Much of the recent progress has been made in locoregionally advanced inoperable disease, mainly with the optimal combination of concurrent chemoradiotherapy and with the introduction of new active drugs, such as docetaxel, in the induction phase of the treatment. The association of docetaxel, cisplatin, and 5-fluorouracil (TPF) regimen is now acknowledged as being the gold standard of induction treatment. The subset of patients with recurrent/metastatic disease still carries a grim prognosis. For the time being, new biological therapies have not dramatically changed this scenario, even in combination with conventional treatments. Little is known about the role of docetaxel and, in general, of chemotherapy in the adjuvant setting, even though it is increasingly acknowledged that, beyond a certain risk, concurrent adjuvant chemoradiotherapy is required. The main aim of the research on head and neck cancer probably lies in the identification of biomolecular markers that are able to predict clinical behaviour, thus allowing appropriate treatment tailoring. The identification of human papilloma virus infection as the agent of a particular form of oropharyngeal cancer is an example of this strategy in consideration of the peculiar characteristics.