Place des thérapies moléculaires ciblées dans le traitement des cancers de la tête et du cou

Patients with recurrent or metastatic squamous cell carcinoma of the head and neck have a poor prognosis. After first-line chemotherapy, therapeutics are limited. For several years, the only approved targeted therapy has been cetuximab, which is a monoclonal antibody that binds to the epidermal growth factor receptor. No predictive biomarkers of response have been identified. The use of high-throughput molecular techniques has allowed characterizing the different molecular abnormalities involved in the carcinogenesis of squamous cell carcinoma of the head and neck and considering new therapeutic targets, including PI3K/AKT/mTOR pathway, NOTCH, and FGF/FGFR. Targeting the microenvironment appears to be an important area of research. The major known risk factors are environmental exposure to tobacco products and alcohol; however, infection with human papillomavirus (HPV) has a rising role in the occurrence of oropharyngeal squamous cell carcinomas. The carcinogenesis of these two entities is different, therefore, different treatments and targeted therapies need to be considered.