Treatment of Metastatic Head and Neck Cancer: Chemotherapy and Novel Agents

For more than a decade, the de facto "standard of care" for palliative mangement of recurrent head/neck squamous carcinoma (HNSCC) has been the combination of cisplatin/5-flourouracil. With the advent of new cytotoxins, such as the taxanes, and of the molecularly targeted agents, eg., the EGFR inhibitors, the number of options for treatment in this setting has increased. However, none of these new approaches has yet been proven to be more effective than cisplatin/5-fluorouracil. Further, despite the pallitive intent of therapy in this setting, the palliative effects have been only infrequently assessed, with many studies relying on response as a surrogate for palliation. This chapter will focus on clinical and translational research efforts in the past decade focusing on the patient with incurable locoregionally recurrent or metastatic HNSCC. Ongoing and planned future trails will also be discussed.