Medical therapy uses drugs to treat cancer. Different classes of drugs — chemotherapy, targeted therapy and immunotherapy — work in different ways. Your treatment team will select the drug or combination of drugs that will best for your cancer. These types of medical treatments are also called systemic therapy because the drugs circulate through your entire body system.
Chemotherapy for head & neck cancer
Head and neck cancer is commonly treated with chemotherapy — for example, cisplatin, carboplatin or docetaxel — and often is combined with radiation therapy, especially when the disease is locally advanced. Chemotherapy attacks cancer cells directly, aiming for cells that are reproducing very quickly. It interferes with the cancer cells’ ability to grow and divide, which damages or kills them.
Targeted therapy for head & neck cancer
Targeted therapies are drugs that find and attack cancer cells by targeting a specific, unique feature of the cancer cell, such as an abnormal mutation or protein that isn’t found in normal, healthy cells.
Head and neck cancer that returns after treatment or has metastasized (spread to other parts of the body) may be treated with a targeted therapy called cetuximab (brand name Erbitux®). It may be given alone or with another chemotherapy drug or combination of drugs (carboplatin or cisplatin with 5FU or paclitaxel).
Cetuximab attaches itself to a protein called epidermal growth factor receptor (EGFR) — which is present on tumor cells and helps them grow faster — and interferes with its functioning. Cetixumab also “marks” the cancer cells so your immune system can find and destroy them.
Potential side effects of cetuximab include rash and diarrhea, which can be managed with medications.
Immunotherapy for head & neck cancer
Immunotherapy drugs use your own immune system to fight the cancer. One type, called anti-PD-1 therapy, is used to treat patients with head and neck cancer that has recurred or metastasized (spread to other parts of the body). It is usually given together with chemotherapy (carboplatin with 5FU or paclitaxel).
Here’s how it works: T cells, which are part of your immune system, have the power to kill cancer cells. However, a protein called PD-1, which is found on the surface of T cells, can link to another protein called PD-L1 and help cancer cells “hide” from the immune system. Anti-PD-1 therapies such as pembrolizumab (Keytruda®) and nivolumab (Opdivo®) latch onto PD-1 and “release the brakes” of your immune system so your T cells can find and kill the cancer cells.