Editorial [Hot Topic:Recent Advances in Molecular Targeting of Head and Neck Cancer (Guest Editor: Dong Moon Shin, M.D.)]

The incidence of squamous cell carcinoma of the head and neck (SCCHN) is expected to reach approximately 45,000 new cases and nearly 12,000 deaths in the United States, and more than 600,000 cases worldwide in the year 2007. The majority of patients who develop this disease are middle-aged males who have a history of tobacco and/or alcohol use. However, there has been an alarming increase in the number of patients with this disease who are under 40 years of age and do not have significant tobacco or alcohol related history. This younger population may have other associated etiologies including human papillomavirus (HPV). More than two-thirds of SCCHN patients will present with locally and regionally advanced disease, and their prognoses are dismal. For these advanced SCCHN cases, aggressive surgical procedures are technically feasible and frequently required, but they result in significant long-term anatomic, functional, physiologic and/or cosmetic sequallae in the surviving patients. This has led to the development of organ preserving treatment strategies. In contrast to the poor prognosis of patients with advanced disease (stage III or IV), SCCHN is a potentially curable malignancy when diagnosed at an early stage (stages I/II). Therefore, early detection of this disease is a very important strategy to increase survival. Furthermore, the prevention of invasive cancer is even more critical in decreasing the incidence of the disease. Multidisciplinary approaches using surgery, radiation therapy, chemotherapy, or combined modalities have proven to be effective treatments for advanced disease, albeit with significant toxic effects. Recently developed molecularly-targeted agents alone or in combination with conventional treatment modalities are very important strategies to minimize toxicity and maximize treatment effects. Included in this issue of Current Cancer Drug Targets are articles that address important issues regarding cancer prevention, molecularlytargeted therapy, induction chemotherapy and concurrent chemo-radiation therapy to reduce the incidence of this disease and provide effective treatments. These articles discuss epidermal growth factor receptor (EGFR) antibodies while focusing on their biology, their use with radiation therapy, and the use of cetuximab or erbitux in particular, with or without chemotherapy. Also, EGFR tyrosine kinase inhibitors alone or in combination with chemotherapy are important strategies to improve the outcome of therapy, and are considered within. Another area touched upon in this issue is angiogenesis in SCCHN with an approach to treatment with anti-angiogenesis agents. We also focus on reviewing the recent advances in chemotherapy, particularly for locally advanced disease as induction chemotherapy with concurrent chemo-radiation in previously untreated patients and post-operative settings. Other areas covered include immunology and vaccine development for head and neck cancer and also an understanding of invasion and metastasis as well as biomarkers, pathology, and biology in head and neck cancer. Finally, to decrease the incidence of SCCHN, prevention approaches are critical, which we address by reviewing chemoprevention strategies with novel compounds. In conclusion, this series of review articles is intended to provide readers with a timely review of the recently developed multimodality therapies and molecularly-targeted agents in head and neck cancer and perhaps stimulate new thinking and shape future investigation in this important area of research.