Insulin-like growth factor-1 receptor inhibitor, AMG-479, in cetuximab-refractory head and neck squamous cell carcinoma

Recurrent and/or metastatic head and neck squamous cell carcinoma (HNSCC) remains one of the most difficult cancers to treat with limited chemotherapeutic options. Here, we describe a patient with HNSCC who had complete response to methotrexate (MTX) after progressing on multiple cytotoxic agents; cetuximab, a monoclonal antibody (mAb) against Epidermal Growth Factor Receptor (EGFR), and AMG 479, a mAb against Insulin-like Growth Factor-1 Receptor (IGF-1R). In tumor tissue of this patient we observed gene expression modulation by cetuximab and AMG 479 suggesting crosstalk between the EGFR and IGF-1R pathways that may have sensitized the tumor to MTX. This represents a promising novel approach to development of targeted agents in refractory cancer. Keywords: tumor response 10 samples from different time points during course of treatment in a single individual.