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The Value of Anti-angiogenics in Head and Neck Cancer Therapy

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Tumor Angiogenesis

Abstract

Squamous cell carcinoma of the head and neck is mostly diagnosed at an advanced stage, and the prognosis remains poor despite advances in the multimodality treatments involving surgery, radiotherapy, chemotherapy, and/or targeted therapy. Improvement in understanding the molecular biology of cancer has led to new promising research strategies, as the development of molecular-targeted therapies like anti-angiogenic therapies. The monoclonal antibody inhibiting VEGF (vascular endothelial growth factor), bevacizumab, has been studied in combination with chemotherapy and/or anti-EGFR (epidermal growth factor receptor) therapy (cetuximab) and radiation therapy in the locally advanced setting and in combination with chemotherapy and/or targeted therapies in the recurrent/metastatic setting. Activity has been shown in preliminary studies, and phase III trials are currently ongoing with bevacizumab and chemotherapy in the recurrent/metastatic setting. Tyrosine kinase inhibitors targeting VEGFR have been reported as not effective when used as monotherapy, warranting combinations with radiation therapy, chemotherapy, or other targeted therapies. A major concern of targeting angiogenesis in squamous cell carcinoma is the risk of increased bleeding, especially in pretreated areas. A careful selection of patients is mandatory to minimize the risk of severe bleeding adverse events in future trials exploring anti-angiogenics that are not recommended in routine practice in head and neck cancers. Validating biomarkers to better select patients who will benefit of anti-angiogenic therapy is also a key point for further development of these therapies in the treatment of head and neck squamous cell carcinoma.

Conflict of interest: SF has received consultancy compensation from Bayer, Merck Serono and Pfizer

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Author information

Authors and Affiliations

  1. Medical Oncology, University Hospital CHUV, Lausanne, Switzerland

    Valérie Cristina

  2. Medical Oncology, University Hospital Nord Val de Seine (HUPVNS), Paris 7 University, Paris, France

    Sandrine Faivre

  3. Medical Oncology, Beaujon Hospital, Clichy, France

    Sandrine Faivre

Authors
  1. Valérie Cristina
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  2. Sandrine Faivre
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Correspondence to Sandrine Faivre .

Editor information

Editors and Affiliations

  1. Tumor Biology Center, Freiburg, Baden-WĂĽrttemberg, Germany

    Dieter Marmé

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Cristina, V., Faivre, S. (2019). The Value of Anti-angiogenics in Head and Neck Cancer Therapy. In: Marmé, D. (eds) Tumor Angiogenesis. Springer, Cham. https://doi.org/10.1007/978-3-319-33673-2_21

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