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Current Role of Dacomitinib in Head and Neck Cancer
Olgun Elicin1, Mahmut Ozsahin2
1a Department of Radiation Oncology, Inselspital , Bern University Hospital and University of Bern , Bern , Switzerland.
Introduction:
Recurrent and/or metastatic head and neck squamous cell carcinoma (HNSCC) has a dismal prognosis. With the emergence of monoclonal antibodies and tyrosine kinase inhibitors (TKI) targeting the epidermal growth factor receptor (EGFR), several drugs were developed and tested in HNSCC. To date, the monoclonal antibody cetuximab is the only approved therapy for curative and recurrent/metastatic patients. Other EGFR-targeting drugs either failed in the clinical trials or are still in the early phases of drug development and research.
Areas Covered:
In this article, previously published data and ongoing studies regarding dacomitinib, a second-generation irreversible TKI, for the treatment of HNSCC are presented and discussed.
Expert Opinion:
The current body of evidence is not mature enough to indicate the use of dacomitinib for the treatment of HNSCC in curative or in recurrent/metastatic settings. Phase II data suggest the potential of improved outcome in selected recurrent/metastatic HNSCC based on several biomarkers, which need to be evaluated in randomized phase III trials. Meanwhile, an ongoing phase I study is investigating dacomitinib's optimal dosing combined with and without cisplatin in the curative concomitant chemoradiotherapy setting.
Insights
Dacomitinib shows potential for treating head and neck squamous cell carcinoma (HNSCC), but more research is needed. Biomarker evaluation in phase III trials is crucial for recurrent/metastatic HNSCC treatment.
Area of Science:
- Oncology
- Pharmacology
Background:
- Recurrent/metastatic head and neck squamous cell carcinoma (HNSCC) has a poor prognosis.
- Epidermal growth factor receptor (EGFR) inhibitors, including monoclonal antibodies and tyrosine kinase inhibitors (TKIs), have been developed for HNSCC.
- Cetuximab is the only approved EGFR-targeting therapy for HNSCC.
Purpose of the Study:
- To present and discuss previously published data and ongoing studies on dacomitinib for HNSCC treatment.
- To evaluate the potential of dacomitinib in curative and recurrent/metastatic settings.
Main Methods:
- Review of previously published data on dacomitinib in HNSCC.
- Discussion of ongoing clinical studies, including phase I and phase II trials.
- Exploration of dacomitinib's efficacy in combination with cisplatin.
Main Results:
- Current evidence is insufficient to recommend dacomitinib for HNSCC in curative or recurrent/metastatic settings.
- Phase II data suggest potential benefits in selected recurrent/metastatic HNSCC patients based on biomarkers.
- An ongoing phase I study is assessing optimal dosing of dacomitinib with or without cisplatin.
Conclusions:
- Further randomized phase III trials are necessary to validate biomarker-driven efficacy of dacomitinib.
- Dacomitinib's role in HNSCC treatment requires more mature evidence.
- Ongoing research is exploring dacomitinib's combination therapy and optimal dosing in HNSCC.
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