Targeting the Tumor Environment in Squamous Cell Carcinoma of the Head and Neck

  • Sandra SchmitzEmail author
  • Jean-Pascal Machiels
Head and Neck Cancer (J-P Machiels, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Head and Neck Cancer

Opinion statement

The survival rate for patients with advanced stages of squamous cell carcinoma of the head and neck (SCCHN) remains poor despite multimodal treatment options. Cetuximab, an anti-EGFR inhibitor, is the only FDA-approved targeted agent for this disease. Recent findings have implicated modifications of the microenvironment and, consequently, phenotypical modifications of the cancer cell, in treatment resistance mechanisms. For many years, cancer research has focused mainly on targetable sites on or inside the cancer cell. Nowadays, in preclinical and clinical studies, a greater emphasis is being placed on drugs that target the tumor microenvironment. Potential targets relate to tumor vascularization, immunology, extracellular matrix components, or cancer-associated fibroblasts. The combination of these new agents with standard treatment options is of particular interest to overcome resistance mechanisms and/or to increase treatment efficacy. Whereas antiangiogenic agents show poor clinical activity, immunotherapy seems to be a more promising tool with an objective response rate (ORR) of 20 % in patients with recurrent and/or metastatic squamous cell carcinoma (R/M SCC). Other targets, located inside the extracellular matrix or on cancer associated fibroblasts, are under preclinical investigation. These new agents all need to be tested in clinical trials alone, or in combination with standard treatment modalities, based on preclinical data. To increase our knowledge of the complex network between the cancer cell and its environment, preclinical studies should consider co-culture models, and clinical studies should incorporate a translational research objective.


Squamous cell carcinoma Head and neck cancer Angiogenesis Immunology New treatment options Extracellular matrix Cancer associated fibroblasts Preclinical data Clinical data 



The authors wish to thank Aileen Eiszele for writing assistance.

Compliance with Ethical Standards

Conflict of interest

Sandra Schmitz and Jean-Pascal Machiels declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human and animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Institut Roi Albert II, Department of Head and Neck Surgery, Cliniques Universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale (MIRO)Université Catholique de LouvainBrusselsBelgium
  2. 2.Institut Roi Albert II, Department of Medical Oncology, Cliniques Universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale (MIRO)Université Catholique de LouvainBrusselsBelgium

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