Personalized Treatment with Erbitux in Head and Neck Cancer Promising

Researchers from UCLA have reported that a short course of the drug Erbitux® (cetuximab) in combination with standard chemotherapy and radiation improves survival in individuals diagnosed with advanced head and neck squamous cell carcinoma and the KRAS genetic mutation.

Head and neck cancers originate in the throat, larynx (voice box), pharynx, salivary glands, or oral cavity (lip, mouth, tongue). Most head and neck cancers involve squamous cells, which are cells that line the mouth, throat, or other structures.  Globally, head and neck cancer comprises the seventh most common type of cancer with an estimated 400,000-600,000 diagnoses every year.

Erbitux is a type of targeted therapy called a monoclonal antibody. It works by binding to a protein receptor located on many cancer cells called the epidermal growth factor receptor (EGFR). EGFR is involved in cellular growth and replication, and by targeting EGFR, the spread of cancer can be reduced or delayed. The majority of squamous cell head and neck cancers have some type of mutation within EGFR.

In 2006, researchers discovered the KRAS-variant, an inherited genetic mutation found in up to 25 percent of people with cancer. The mutation has been shown to predict response to cancer therapy for many cancers, including head and neck cancer. It was not previously understood exactly how this biomarker worked.

In the current analyses doctors from UCLA analyzed available samples from a previous phase 3 clinical trial of Erbitux in combination with chemotherapy and radiation therapy.  The researchers accessed 413 biological samples from participants in the trial. They found a significant benefit of Erbitux treatment for all people with the KRAS-variant. Furthermore, the team found that Erbitux may in fact be working by helping the immune system of people with the KRAS-variant better fight their cancer.

The result of the study indicate the KRAS-variant’s potential to identify people with head and neck cancers who will respond differently to therapies that depend on the immune response. Using the KRAS-variant and biomarkers like it to personalize radiation therapy as well as developing immune therapies for all cancer is very promising.

Reference: Weidhass J, Harris J, Schaue D, et al. The KRAS-Variant and Cetuximab Response in Head and Neck Squamous Cell Cancer: A Secondary Analysis of a Randomized Clinical Trial. JAMA Oncol. Published online December 22, 2016. doi:10.1001/jamaoncol.2016.5478

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