In head and neck oncology area as well as other oncology areas, development of molecular targeting agents has been active. More specifically in head and neck cancer, induction chemotherapy has been in the spotlight since 2007. I would like to discuss an updated evidence of chemotherapy for head and neck cancer, especially focus on the induction chemotherapy and molecular targeting agents in this session.
In locally advanced head and neck cancer, Vermorken and Posner in 2007 reported that induction chemotherapy with docetaxel + cisplatin + 5FU (TPF) had significantly improved overall survival. Since then, TPF has been one of the standard treatments as induction chemotherapy. Phase III trials, comparing TPF followed by chemoradiotherapy (CRT) with CRT, are still ongoing. So, we have to wait for the results and expect that TPF followed by CRT become a new standard treatment for locally advanced head and neck cancer.
Addition of molecular targeting agents to CRT and induction chemotherapy is one of the attractive treatment strategies for locally advanced head and neck cancer (LAHNC). However, according to the result from RTOG0522, addition of cetuximab to CRT did not show the superiority to CRT. We still continue to seek how to integrate molecular targeting agents into definitive treatment strategy for LAHNC.
In recurrent or metastatic head and neck cancer, anti-EGFR inhibitor has shown significant efficacy. So, many anti-EGFR inhibitors and anti-angiogenesis inhibitors have been under investigation. Especially in thyroid cancer, anti-angiogenesis inhibitors has shown promising efficacy.