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Treatment options for patients with recurrent or metastatic squamous cell carcinoma of the head and neck, who progress after platinum-based chemotherapy

de Andrade, Diocésio A.P.; Machiels, Jean-Pascal

doi: 10.1097/CCO.0b013e3283510773
HEAD AND NECK: Edited by Gilberto de Castro

Purpose of review After multimodal treatment, 50–60% of patients with locally advanced squamous cell carcinoma of the head and neck will present locoregional and/or distant relapse within 2 years. This article will review chemotherapy and/or targeted agents as treatment options for patients who progress after platinum-based chemotherapy.

Recent findings After years when the only therapeutic option was palliative chemotherapy, monoclonal antibodies targeting the epidermal growth factor receptor have emerged as new treatments. In particular, cetuximab and panitumumab have demonstrated progression-free survival and/or overall survival benefits in the first-line palliative treatment when given in combination with platinum-based chemotherapy. Recently, second-generation compounds (zalutumumab) or irreversible pan-human epidermal receptor (pan-HER) inhibitors have also shown promising activity after platinum failure.

Summary Because median overall survival after platinum failure is less than 1 year, there is a clear requirement for new phase II/III studies with agents that have the potential to improve overall survival and quality of life. The previous use of platinum-based chemotherapy and the type of tumor response observed may substantially impact prognosis. Therefore, prior platinum use should be clearly defined in future clinical trials to enable a more accurate interpretation of the data.

Department of Medical Oncology, Centre du Cancer, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium

Correspondance to Jean-Pascal Machiels, Department of Medical Oncology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium. Tel: +32 2 764 54 57; fax: +32 2 764 5428; e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.