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Dual Epidermal Growth Factor Receptor and Human Epidermal Growth Factor Receptor 2 Inhibition in Squamous Cell Carcinoma of the Head and Neck; Is the Jury Still Out?

TO THE EDITOR: In squamous cell carcinoma of the head and neck (SCCHN), the overall response rate to cetuximab as a single agent does not exceed 13%, with a median response duration of less than 70 days and median progression-free survival for patients receiving first-line therapy of approximately 6 months. In addition, acquired resistance emerges over time and has been recently linked to compensatory signaling from other epidermal growth factor receptor (EGFR) family receptors, such as human epidermal growth factor receptor 2 (HER2) and HER3, stressing the need for alternative approaches to EGFR inhibition in SCCHN. We read with interest the results of Harrington et al regarding postoperative lapatinib in the concurrent setting followed by maintenance lapatinib in high-risk SCCHN, and we believe dual EGFR and HER2 targeting is a rational approach in SCCHN, given the encouraging results from prior phase I and II studies using lapatinib in this setting.