Consideration of the efficacy of targeted agency from foreign phase III trial for head and neck malignant tumor

Abstract

The epidermal growth factor receptor (EGFR) is over-expressed in many patients of head and neck squamous cell carcinoma (HNSCC). The high EGFR expression is associated with poor prognosis. Cetuximab is an IgG1 monoclonal antibody which binds to the EGFR. It is the only targeted agent, which got approval for the treatment of HNSCC, for cetuximab had improved overall survival (OS) time of locoregionally advanced HNSCC patients or incurable (recurrent/metastatic) patients combined with radiotherapy or chemotherapy. However cetuximab plus radiotherapy (BRT) still had some issues which should be resolved by additional clinical studies in the future, such as the efficacy of BRT seemed to be restricted to oropharnygeal carcinoma or treatment in the United States with subgroup analysis. There had been no phase III trial of targeted agency for HNSCC patients which cleared the primary endpoint except for cetuximab. while we have not found any targeted agency which surpassed the outcome of conventional standard treatment for HNSCC patients, ipilimumab of cytotoxic T cell antigen 4 inhibitor and vemurafenib of BRAF mutation inhibitor for malignant melanoma had improved OS time and accepted for the standard treatment. It is expected that many targeted agencies will improve OS time and QOL of HNSCC patients compared to conventional standard treatments in the future.