Clinical trial design in advanced head and neck cancer: from past experiences to future perspectives

Author(s): Gilberto de Castro Jr, Carlos Henrique dos Anjos, Yassine Lalami,Ahmad Awada

Head and neck squamous cell carcinoma (HNSCC) is usually diagnosed in advanced stages and it is more prevalent in the developing world, as a consequence of heavy exposure to smoking, alcohol drinking and human papillomavirus infection. Current multidisciplinary treatment includes surgery and/or radiation therapy in early stages, cisplatin-based concurrent chemoradiation in locally advanced disease and chemotherapy in patients with relapsed/metastatic HNSCC. Molecular targeted therapies, especially directed to the EGFR, have also been incorporated in the current therapeutic armamentarium. However, the low long-term overall survival and the high rate of acute and late toxicities still remain problematic. In this article, the authors aim to briefly review and discuss some aspects to be better addressed in future clinical studies in advanced HNSCC.