With
greater understanding of the cellular changes that cause cancer, newer drugs
that specifically target these changes have been developed. Targeted drugs work
in a different way than regular chemotherapy agents. They also often have
different (and usually less severe) side effects.
Nivolumab (Opdivo®) injection, for intravenous use, was approved by the FDA for the
treatment of patients with recurrent or metastatic squamous cell carcinoma of the
head and neck (SCCHN) with disease progression on or after platinum-based
therapy. Nivolumab is a human immunoglobulin G4 (IgG4) monoclonal
antibody that binds to the PD-1 receptor and blocks its interaction with PD-L1
and PD-L2, releasing PD-1 pathway-mediated inhibition of the immune response,
including the anti-tumor immune response. Nivolumab treatment was proven in a phase
3 trial to significantly extend overall survival for patients with SCCHN.
Side
effects include: fatigue, rash, itching, cough, upper respiratory tract
infection, swelling of the extremities, shortness of breath, and muscle pain.
Cetuximab
(Erbitux®) is a monoclonal antibody (which is a manufactured version of an
immune system protein) that targets epidermal growth factor receptor (EGFR), a
protein on the surface of certain cells that helps them grow and divide. Oral
cavity and oropharyngeal cancer cells often have more than normal amounts of
EGFR. By blocking EGFR, cetuximab can slow or entirely stop cell growth.
Cetuximab
can be administered in combination with radiation therapy for some earlier
stage cancers. For more advanced cancers, it can be combined with standard chemotherapeutic
drugs such as cisplatin, or it may be
used by itself.
Cetuximab
is administered by infusion into a vein (IV), generally once a week. Side effect
of cetuximab include allergic reaction during the first infusion and skin
problems such as an acne-like rash on the face and chest, headache, tiredness,
fever, and diarrhea.
Several
other drugs that target EGFR are now being studied as well, some of which are
already being used to treat other types of cancers.
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