Clinical Medicine Reviews in Oncology

The worldwide incidence of head and neck cancer exceeds half a million cases annually with squamous-cell histology as the most predominant. Almost half of newly diagnosed cases have advanced disease at diagnosis. The high morbidity and mortality associated with the malignancy has brought more attention to this cancer. The improvement in the diagnosis and management has resulted in considerable improvements in quality of life and survival. EGFR is constitutively expressed in squamous-cell carcinoma of the head and neck (SCCHN) paving the path for evaluation of EGFR targeted agents. Cetuximab is a chimeric monoclonal antibody that targets the extracellular epitope in the EGFR ligand-binding domain. It was initially approved by the Food and Drug Administration, FDA, in 2006 for use in SCCHN in combination with radiation therapy based on improvement in both locoregional control and survival. In addition, it is efficacious as a single agent in patients with failure after prior platinum-based chemotherapy and is also indicated in combination with platinum-based chemotherapy in first-line recurrent or metastatic SCCHN. This paper reviews the mechanism of action, clinical studies, safety and efficacy of cetuximab in SCCHN.