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Targeted Therapy in Head and Neck Cancer: An Update on Current Clinical Developments in Epidermal Growth Factor
Jonathan Moreira1, Alexander Tobias2, Michael P O'Brien3
1Division of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL, USA.
Abstract:
Most patients diagnosed with head and neck squamous cell carcinoma (HNSCC) will present with locally advanced disease, requiring multimodality therapy. Despite this curative approach, a significant subset of these patients will develop locoregional failure and/or distant metastases. Despite significant progress in the treatment and subsequent prognosis of locally advanced HNSCC, the prognosis of those patients with recurrent and/or metastatic (R/M) HNSCC is poor, with short-lived responses to palliative chemotherapy and few therapeutic agents available. The discovery of the integral role of epidermal growth factor receptor overexpression in the pathogenesis of HNSCC, coupled with emerging data on the role of tumor evasion of the immune system, has opened new pathways in the development of novel therapeutic agents for the treatment of R/M HNSCC. As a result, cetuximab, a monoclonal antibody targeting epidermal growth factor receptor, as well as pembrolizumab and nivolumab, monoclonal antibodies targeting programmed cell death 1 (PD-1), are now US Food and Drug Administration approved for the treatment of R/M HNSCC. This review will detail the data supporting the use of these agents, as well as clinical trials evaluating the efficacy of other novel and promising drugs.
Insights
New therapies target head and neck squamous cell carcinoma (HNSCC). Immunotherapy and EGFR inhibitors offer hope for recurrent and metastatic HNSCC patients, improving outcomes beyond traditional chemotherapy.
Area of Science:
- Oncology
- Immunology
- Molecular Biology
Background:
- Head and neck squamous cell carcinoma (HNSCC) often presents as locally advanced disease, necessitating multimodality treatment.
- Despite curative attempts, a substantial number of HNSCC patients experience locoregional failure or distant metastasis.
- The prognosis for recurrent and/or metastatic (R/M) HNSCC remains poor, with limited effective therapeutic options.
Purpose of the Study:
- To review novel therapeutic agents for R/M HNSCC.
- To discuss the role of epidermal growth factor receptor (EGFR) and immune evasion in HNSCC pathogenesis.
- To present data supporting approved agents and ongoing clinical trials.
Main Methods:
- Literature review of clinical trials and therapeutic data.
- Analysis of targeted therapies including monoclonal antibodies.
- Examination of immunotherapeutic approaches.
Main Results:
- Cetuximab, targeting EGFR, is approved for R/M HNSCC.
- Pembrolizumab and nivolumab, targeting PD-1, are also FDA-approved for R/M HNSCC.
- Emerging data supports the efficacy of these novel agents.
Conclusions:
- Targeting EGFR and immune checkpoints represents a significant advancement in R/M HNSCC treatment.
- Approved therapies offer improved outcomes for patients with advanced HNSCC.
- Ongoing research continues to explore novel drugs for this challenging disease.