title: Afatinib in the treatment of head and neck squamous cell carcinoma.
abstract: BACKGROUND
  Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cause of cancer death in the United States. Treatment of locally advanced disease is associated with significant acute side effects and can lead to chronic disabilities, while the prognosis of recurrent or metastatic disease is very poor. This highlights the need for better therapeutic options. Epidermal growth factor receptor is overexpressed in 90% of HNSCC patients and is an attractive therapeutic target in this patient population. Afatinib is a potent, irreversible pan-ErbB inhibitor. Preliminary studies in HNSCC show promising activity.
  
  
  METHODS
  This article reviews the current data evaluating small molecules inhibitors of the ErbB family in the treatment of HNSCC with a specific emphasis on afatinib, a second-generation, irreversible, pan-ErbB inhibitor. It also provides a description of afatinib's drug characteristics, pharmacokinetics and toxicity profile as well as details of the published and ongoing clinical trials evaluating its efficacy in HNSCC patients.
  
  
  CONCLUSIONS
  Phase II trials in HNSCC show that daily oral treatment with afatinib is tolerable. Most common toxicities are skin rash and diarrhea. Afatinib has clinical activity as a single agent in a subset of refractory and/or metastatic HNSCC patients. It is thought that ongoing Phase III trials should better clarify the role of this compound in the treatment of HNSCC.
authors.affiliation: The University of Texas MD Anderson Cancer Center, Department of Thoracic and Head and Neck Medical Oncology , 1515 Holcombe Blvd, Unit 0432, Houston, TX 77030 , USA.
authors.forename: Renata
authors.initials: R
authors.lastname: Ferrarotto
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Gold
mesh_terms: D000077716:Afatinib; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D006258:Head and Neck Neoplasms / Q000188:drug therapy*; D006801:Humans; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D011799:Quinazolines / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000077195:Squamous Cell Carcinoma of Head and Neck; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000077716:Afatinib; D066246:ErbB Receptors