Management of metastatic head and neck squamous cell carcinomas

Though a majority of head and neck squamous cell carcinomas are diagnosed in a locally advanced stage, a majority will experience a local and/or distant relapse. The management is multidisciplinary. Enrollment in clinical trial should be preferred. The combination of a platinum salt, 5-FU and cetuximab is the current standard first-line treatment for patients with good general condition. After failure to platinum salts, a mono-chemotherapy with taxans, intravenous methotrexate or cetuximab may be proposed, best supportive remaining an option. The better knowledge of the biology of these tumors should improve the effectiveness of treatments.