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Cetuximab: its unique place in head and neck cancer treatment

Authors Specenier P, Vermorken JB

Received 3 February 2013

Accepted for publication 19 February 2013

Published 15 April 2013 Volume 2013:7 Pages 77—90

DOI https://doi.org/10.2147/BTT.S43628

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 6

Pol Specenier, Jan B Vermorken

Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium

Abstract: Head and neck cancer is the sixth most common cancer worldwide. At present, globally about 650,000 new cases of squamous cell carcinoma of the head and neck (SCCHN) are diagnosed each year. The epidermal growth factor receptor (EGFR) is almost invariably expressed in SCCHN. Overexpression of the EGFR is a strong and independent unfavorable prognostic factor in SCCHN. Cetuximab is a chimeric monoclonal antibody, which binds with high affinity to the extracellular domain of the human EGFR, blocking ligand binding, resulting in inhibition of the receptor function. It also targets cytotoxic immune effector cells towards EGFR-expressing tumor cells (antibody dependent cell-mediated cytotoxicity). The addition of cetuximab to radiotherapy (RT) improves locoregional control and survival when compared to RT alone. The addition of cetuximab to platinum-based chemoradiation (CRT) is feasible but does not lead to an improved outcome. Cetuximab plus RT has never been compared prospectively to CRT, which therefore remains the standard treatment for patients with locoregionally advanced SCCHN for whom surgery is not considered the optimal treatment, provided they can tolerate CRT. The addition of cetuximab to platinum-based chemotherapy prolongs survival in patients with recurrent or metastatic SCCHN. The combination of a platinum-based regimen and cetuximab should be considered as the standard first line regimen for patients who can tolerate this treatment.

Keywords: SCCHN, cetuximab, recurrent metastatic, locoregionally advanced, chemoradiation

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