Head and neck cancer: the role of anti-EGFR agents in the era of immunotherapy.

Head and neck cancers (HNC) represent the seventh most frequent cancer worldwide, with squamous cell carcinomas as the most frequent histologic subtype. Standard treatment for early stage diseases is represented by single modality surgery or radiotherapy, whereas in the locally advanced and recurrent or metastatic settings a more aggressive multi-modal approach is needed with locoregional intervention and/or systemic therapies. Epidermal Growth Factor Receptor (EGFR) plays an important role in HNC biology and has been studied extensively in preclinical and clinical settings. In this scenario, anti-EGFR targeted agent cetuximab, introduced in clinical practice a decade ago, represents the only approved targeted therapy to date, while the development of immune-checkpoint inhibitors has recently changed the available treatment options. In this review, we focus on the current role of anti-EGFR therapies in HNCs, underlying available clinical data and mechanisms of resistance, and highlight future perspectives regarding their role in the era of immunotherapy.

Microvessel density and vascular endothelial growth factor (VEGF) expression in human radicular cysts.

PURPOSE: To assess vascular endothelial growth factor (VEGF) expression and microvessel density (MVD) by immunohistochemistry and to relate them to the inflammatory status in a sample of radicular cysts. METHODS: Specimens of 24 human radicular cysts were examined by immunohistochemistry using antibodies anti-VEGF and anti-CD34 and to evaluate vascular density. Integrity of the epithelium and inflammatory state of the connective tissues were evaluated and related with the immunohistochemical findings. A Spearman correlation test was utilized to compare the means of each parameter. RESULTS: VEGF immunoreactivity was detected in both epithelial and connective tissues of radicular cysts. Stromal cells showed higher levels of VEGF expression when compared to epithelial cells. MVD proved to be related to VEGF expression levels (P < or = 0.01). In addition, increased MVD was associated with high levels of inflammation (P < or = 0.01). Most of the specimens showed a massive inflammatory infiltrate in the connective tissue. The integrity of the cystic lining tend to decrease with increased inflammation.