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Cetuximab and cisplatin for chemotherapy-refractory squamous cell cancer of the head and neck.

Squamouscellcarcinomaoftheheadandneckremains a challenging clinical problem. The majority of patients who present with stage III and IV disease will not be cured by chemoradiotherapy or surgery, and metastatic disease is increasingly common with the use of successful regimens for treatment of locoregional disease. Systemic therapies have not been curative, and median survival times have remained less than a year for patients with recurrent or metastatic disease. Head and neck cancers are rich in expression of the epidermal growth factor receptor (EGFR), which has been proposed as an important therapeutic target in these tumors. 1 Overexpression has been associated with worse prognosis. 2 Activated EGFR signals via the ras, ERK1/2, PI3K/Akt, and stat pathways and results in treatment resistance,angiogenesis,enhancedproliferation,andexpression