Molecular targeted therapies in all histologies of head and neck cancers: an update

This article reviewed the recent developments in molecular targeted therapy in head and neck cancers. A brief summary of other pathways of interest is also enclosed.

The use of cetuximab in squamous cell head and neck cancer is associated with clinical benefit and, in some cases, survival. However, the use of targeted agents beyond cetuximab in this disease remains investigational. Combination therapy of molecular targeted agents with chemoradiation in the locally advanced setting of head and neck squamous cell carcinomas and nasopharyngeal cancer shows early promising results, but at the expense of increased toxicity. In malignant salivary gland tumors, the evaluation of targeted therapy has been disappointing. New therapeutic targets warrant further evaluation in these cancers.

Despite the encouraging results achieved with antiepidermal growth factor receptor therapy, particularly with cetuximab, targeted therapy trials conducted in head and neck cancers to date have largely lacked efficacy or are associated with significant toxicity. Further research into modulation of other aberrant pathways is needed. The recent identification of improved prognosis among head and neck squamous cell carcinoma patients whose tumors harbor the human papilloma virus may allow better treatment selection for these patients, while the identification of a hallmark gene fusion transcript in adenocystic carcinoma may herald new treatment promise.