Recent multidisciplinary approach with molecular targeted drugs for advanced head and neck cancer.

The multidisciplinary approach is becoming the standard for treatment of advanced head and neck cancer. Combined modality treatment preserves quality of life as well as improving the length of survival time. Molecular targeted drugs have become very important in the multidisciplinary approach for the treatment of advanced head and neck cancer. Cetuximab has been shown to have locoregional control and additional survival benefits in locally advanced squamous cell carcinoma of the head and neck as well as additional survival benefits in distant metastatic/recurrent squamous cell carcinoma of the head and neck. Recently, many clinical studies of the multidisciplinary approach including cetuximab have been carried out in Europe and the US. It has been shown that cetuximab in combination with radiotherapy (RT) is significantly superior to the RT alone in median locoregional control duration and median overall survival (OS). For recurrent or metastatic disease, the results of a phase III randomized control study of CDDP + 5-fluorouracil combination therapy with or without cetuximab reported that OS was significantly longer with than without cetuximab, demonstrating an additional survival benefit of cetuximab. Many trials including induction chemotherapy are being conducted. Clinical trials with cetuximab have also been conducted in Japan. Though combination with cetuximab shows some benefit, further studies are necessary to obtain the standard treatments for a multidisciplinary approach for advanced head and neck cancer.