Targeted therapy in head and neck cancer

PURPOSE OF REVIEW: Results of clinical studies on targeted cancer therapies are rapidly accumulating. This is also true in the field of head and neck cancer (HNC). Due to the unique multidisciplinary needs of the disease, it is of paramount importance that physicians who treat HNC are aware of the evolving changes that research is offering. RECENT FINDINGS: Many targeted agents directed at inhibiting epithelial growth factor receptors (EGFRs) are under investigation in both curable loco-regional advanced disease in combination with standard treatments and in the recurrent metastatic setting. Human papilloma virus (HPV)-positive tumors present a distinct biological profile. Consequently, the role of targeted agents in this specific setting still needs to be refined. Herein we will briefly review the results of the most recent studies on targeted agents. Cetuximab and other monoclonal antibodies (panitumumab, zalotumumab and nimotumumab) have been already investigated in phase III studies; and some results are now available. Small molecules inhibiting EGFR have still to prove their efficacy. Other agents such as vascular endothelial cell growth factor receptor, vascular endoinsulin-like growth factor 1 receptor, MET, PI3KA and mammalian target of rapamycin inhibitor are in development. SUMMARY: At present treatment options in HNC are changing and include targeted agents with demonstrated efficacy. A better selection based on biological factors of patients who are potentially responsive to such targeted agents is being actively pursued.