Targeted radiotherapy of squamous head and neck cancer

In this chapter the potential applications of radioimmunotherapy (RIT) for the treatment of head and neck squamous cell carcinoma (HNSCC) are outlined. A major aim in the management of head and neck cancer is the development of an effective adjuvant systemic therapy. About 30 monoclonal antibodies (Mabs) reactive with HNSCC are discussed with respect to their suitability for RIT. Only a few of these Mabs have been evaluated in animal models or in HNSCC in patients. Radioimmunoscintigraphy (RIS) and biodistribution studies in HNSCC xenograft-bearing nude mice and HNSCC patients have shown that the radiolabeled Mabs E48 and U36 might be capable of delivery of a tumoricidal dose to HNSCC in patients. On the basis of its physical properties 186Re seems to be a promising radionuclide for treatment of minimal residual HNSCC. The suitability of 186Re for adjuvant RIT is demonstrated in subcutaneous and metastatic tumor models in mice. Progress in the field of 186Re labeling of Mabs for clinical application is described. Aforementioned attainments resulted in the design of clinical RIT studies with 186Re-labeled Mabs in HNSCC patients. The use of RIT in combination with Mabs directed against the epidermal growth factor receptor is highlighted as one of the possibilities to enhance the efficacy of RIT.