Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-27T06:42:38.414Z Has data issue: false hasContentIssue false
  • English
  • Français

Cetuximab: a critical appraisal of a novel development in the treatment of squamous cell carcinoma of the head and neck

Published online by Cambridge University Press:  01 March 2008

Joanna Gemmill
Joanna Gemmill*
Affiliation:
Advanced Practitioner, Head and Neck Cancer, Department of Oncology, Box 193, Cambridge University Hospital Foundation Trust, Addenbrookes Hospital, Hills Road, Cambridge CB2 2QQ, UK
*
Correspondence to: Joanna Gemmill, Advanced Practitioner, Head and Neck Cancer, Department of Oncology, Box 193, Cambridge University Hospital Foundation Trust, Addenbrookes Hospital, Hills Road, Cambridge CB2 2QQ, UK. E-mail: jcgemmill@btinternet.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Recently published evidence has shown an improvement in locoregional control and a survival advantage in the treatment of squamous cell carcinomas of the head and neck (SCCHN) using cetuximab, a monoclonal antibody that inhibits the tumour-promoting mechanism of the epidermal growth factor receptor (EGFR). In a large randomised trial, cetuximab was delivered concurrently with radiotherapy and compared to radiotherapy alone in locally advanced SCCHN. The trial showed that the addition of cetuximab offers improved locoregional control and survival without enhancing acute toxicity compared to radiotherapy alone. These exciting results have the potential to change standard head and neck cancer practice, impacting on head and neck cancer services provided by oncology departments and multidisciplinary working.

This article aims to define the mechanism of action of cetuximab, critically appraise the evidence for the use of cetuximab within Oncology departments for SCCHN, and critically evaluate how cetuximab may impact on current practice. Future possibilities and trials to assess the use of cetuximab within clinical practice will also be discussed.

Keywords

cetuximabchemotherapyhead and neckradiotherapysquamous cell carcinoma
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 7 , Issue 1 , March 2008 , pp. 1 - 7
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

National Institute for Clinical Excellence. Improving Outcomes in Head and Neck Cancer; The Manual 2004. Guidance on Cancer Services. Published by National Institute for Clinical Excellence.Google Scholar
Bhide, S,Nutting, C.Radiotherapy: future direction in head and neck cancer. Oncology News 2007;1 (4):7–9.Google Scholar
Bernier, J, Cooper, J.Chemoradiation after surgery for high-risk head and neck cancer patients: how strong is the evidence? Oncologist 2005;10:215–224.CrossRefGoogle ScholarPubMed
Posner, M.Adjuvant post-operative chemotherapy in head and neck cancer: a standard of care? Oncologist 2005;10:174–175.CrossRefGoogle ScholarPubMed
Brockstein, B, Vokes, E.Concurrent chemoradiotherapy for head and neck cancer. Semin Oncol 2004;31:786–793.CrossRefGoogle ScholarPubMed
Posner, M, Wirth, L.Cetuximab and radiotherapy for head and neck cancer. New Eng J Med 2006;354 (6):634–636.CrossRefGoogle ScholarPubMed
Pfister, D, Su, Y, Kraus, D, et al. Concurrent cetuximab, cisplatin, and concomittant boost radiotherapy for locoreginally advanced, squamous cell head and neck cancer: a pilot phaseii study of a new combined-modality paradigm. J Clin Oncol 2006; 24 (7):1072–1078.CrossRefGoogle Scholar
Bonner, J, Harari, P, Giralt, J, et al. Radiotherapy plus cetuximab for squamous cell carcinoma of the head and neck. New Eng J Med 2006;354 (6):567–578.CrossRefGoogle ScholarPubMed
FDA News. FDA Approves First Head and Neck Cancer Treatment in 45 Years Data Shows Treatment with Erbitux Extends Survival. March 01 2006. www.fda.gov/bbs/topics/NEWS/2006/NEW01329.html. Sourced 22.11.2006Google Scholar
National Institute for Health and Clinical Excellence. Head and Neck Cancer—Cetuximab. www.nice.org.uk/page.aspx last updated 27.11.06.Google Scholar
National Institute for Health and Clinical Excellence. Head and Neck Cancer—Cetuximab. Cetuximab Plus Radiotherapy for the Treatment of Locally Advanced Squamous Cell Carcinoma of the Head and Neck. The Evidence Review Report. 14.05.07. www.nice.org.uk. Accessed 26.10.07Google Scholar
National Institute for Health and Clinical Excellence. Head and Neck Cancer—Cetuximab; Results of Appeal. Published 4.10.07 www.nice.org.uk Accessed 8.10.07.Google Scholar
Grandis, J. Integrating Novel Therapies with Standard Modalities in the Treatment of Head and Neck Cancer. www.medscape.com/viewarticle/541630. Sourced 10.10.2006.Google Scholar
Ang, K, Berkey, B, Tu, X, et al. Impact of epidermal growth factor receptor expression on survival and patterns of relapse in patients with advanced head and neck carcinoma. Cancer Res 2002;62:7350–7356.Google ScholarPubMed
Merck, Oncology. Erbitux (Cetuximab) for the Treatment of Locally Advanced Squamous Cell Carcinoma of the Head and Neck. Merck Oncology August 2006. 300208.Google Scholar
Bourhis, J, Rivera, F, Mesia, R, et al. Phase I/II study of cetuximab in combination with cisplatin or carboplatin and fluorouracil in patients with recurrent or metastatic squamous cell carcinoma of the head and neck. J Clin Oncol 2006;18:2866–2872.CrossRefGoogle Scholar
Robert, F, Ezekiel, M, Spencer, S, et al. Phase I study of anti-epidermal growth factor receptor antibody cetuximab in combination with radiation therapy in patients with advanced head and neck cancer. J Clin Oncol 2001; 19 (13):3234–3243.CrossRefGoogle ScholarPubMed
Pignon, J, Bourhis, J, Domenge, C, et al. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinomas: three meta-analyses of updated individual data. Lancet 2000; 355:949–955.CrossRefGoogle ScholarPubMed
Kings Fund. Future Trends and Challenges for Cancer Services in England; A Review of the Literature and Policy. 2006. Cancer Research UK.Google Scholar
The Royal College of Radiologists. Guidance for the Management of the Unscheduled Interruption or Prolongation of a Radical Course of Radiotherapy. RCR 1996. RCR publications www.rcr.ac.uk/pubtop.Google Scholar
The Royal College of Radiologists. Skills Mix in Clinical Oncology. 1999. RCR publications www.rcr.ac.uk/pubtop.Google Scholar