Table 1.

Current chemotherapeutic models in head and neck cancer

Agent	Mechanism	Mode of Usage in HNSCC	Significant Adverse Effects	Reference
Platinum agents (Cisplatin/Carboplatin)	Formation of DNA adducts, induction of apoptosis and senescence	Cisplatin/Carboplatin single-agent Cisplatin/Carboplatin in combination with 5-Flurouracil	Nephrotoxicity (acute renal failure, chronic renal insufficiency) Ototoxicity (high-frequency hearing loss) Neurotoxicity (peripheral neuropathy) Hematologic (myelosupression) Gastrointestinal (nausea, vomiting) Electrolyte disturbances (hypomagnesiumia/hypokalemia/ hypocalcemia)	[8-12]
5-Flurouracil	Anti-metabolite (pyrimidine analog, inhibits thymidylate synthase)	5-Flurouracil in combination with Cisplatin/Carboplatin, and with or without Paclitaxel	Cardiac toxicity (angina, myocardial ischemia), Gastrointestinal (nausea, omiting, ulcers), Hematologic (myelosupression), Thrombophlebitis, Dermatologic (rash)	[8-10]
Taxanes (Paclitaxel/Docetaxel)	Anti-microtubular agent (inhibitor of mitosis)	Paclitaxel in combination with Carboplatin/Cisplatin, and with or without 5-Fluoruracil	Cardiovascular (hypotension, EKG changes) Gastrointestinal (mucositis, nausea, vomiting) Hematologic (neutropenia, leukopenia, thrombocytopenia), Neuromuscular (peripheral neuropathy, myalgias), Hepatic (elevated liver enzymes)	[9,10]
Cetuximab	Anti-EGFR monoclonal antibody	Cetuximab plus radiation therapy Single-agent cetuximab in platinum refractory HNSCC Phase I/II trial of cetuximab plus 5-FU and platinum agents (on going)	Infusion reaction Dermatologic (acneform rash, pruritis) Gastrointestinal (abdominal pain, constipation, diarrhea, nausea, vomiting), Respiratory (dyspnea, cough), Neuromuscular weakness	[14-17,202]