title: Treatment options for patients with recurrent or metastatic squamous cell carcinoma of the head and neck, who progress after platinum-based chemotherapy.
abstract: OBJECTIVE
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medical Oncology, Centre du Cancer, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Diocésio A P
authors.initials: DA
authors.lastname: de Andrade
authors.forename: Jean-Pascal
authors.initials: JP
authors.lastname: Machiels
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000556:secondary*; D000068818:Cetuximab; D002986:Clinical Trials as Topic; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000187:drug effects; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010166:Palliative Care / Q000379:methods; D000077544:Panitumumab; D017671:Platinum Compounds / Q000008:administration & dosage; D011379:Prognosis; D016019:Survival Analysis; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D017671:Platinum Compounds; D000077544:Panitumumab; C546618:zalutumumab; D066246:ErbB Receptors; D000068818:Cetuximab