Paclitaxel-based chemotherapy for recurrent and/or metastatic head and neck squamous cell carcinoma: current and future directions.

Head and neck squamous cell carcinoma (HNSCC) is a devastating tumor, with enormous repercussions both for the medical system and for the individual patient. Functional and cosmetic morbidity are inherent in head and neck cancer and its treatment, and the economic costs associated with the aggressive therapy needed to battle the disease are substantial. Even with aggressive standard local therapy (surgery and/or radiotherapy), the tumor recurs in approximately 60% of patients with primary disease and the prognosis for those whose disease recurs or metastasizes is poor. In light of these facts, trials of new therapy for recurrent and/or metastatic HNSCC must focus on prolonging survival, improving quality of life, and increasing convenience. The introduction in the 1990s of newer agents such as ifosfamide and the taxanes (paclitaxel [Taxol; Bristol-Myers Squibb Company, Princeton, NJ] and docetaxel) offers hope that these goals can be achieved. All are active against HNSCC and the taxanes, in particular, appear likely to be the most active single agents yet for treating recurrent and/or metastatic HNSCC. This report reviews experience with paclitaxel-based treatment regimens in HNSCC.