Personalized Medicine Approach for an Exceptional Response to Multiple-recurrent and Metastatic HER2-positive Oropharyngeal Squamous Cell Carcinoma

Ann Otol Rhinol Laryngol. 2017 Apr;126(4):334-339. doi: 10.1177/0003489416687309. Epub 2017 Jan 6.


Introduction: Advanced stage squamous cell carcinoma of the head and neck carries an overall poor prognosis, and survivorship gains have remained relatively stagnant compared to other malignancies due to its complex tumor biology and lack of proven effective targeting agents.

Methods: We present a case of an exceptional responder to molecular-targeted therapy for metastatic oropharyngeal squamous cell carcinoma using a chemotherapeutic agent FDA approved for breast cancer and targeting the HER2/Neu receptor in order to discuss the larger clinical implications.

Results: The National Cancer Institute (NCI) has recently instituted the Exceptional Responders Initiative in order to identify such patients with unexpected outcomes in order to expedite the development of additional targeted therapies. This case illustrates the opportunity for cure using targeted oncogene identification in a scenario of recurrent squamous cell carcinoma with lung metastasis typically considered fatal.

Conclusions: Molecular tumor analysis is an infrequently utilized tool in head and neck squamous cell carcinoma; however, as understanding of biologic mechanisms improves, additional molecular targets will become available and expand treatment opportunities such as HER2/Neu targeting. The Exceptional Responders Initiative is a unique strategy with potential to expedite progress.

Keywords: HER2; head and neck cancer; oropharynx cancer; personalized medicine; squamous cell carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / metabolism
  • Carcinoma, Squamous Cell / secondary
  • Cetuximab / administration & dosage
  • Chemoradiotherapy
  • Cisplatin / administration & dosage
  • Docetaxel
  • Fluorouracil / administration & dosage
  • Humans
  • Induction Chemotherapy
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / secondary
  • Lymph Nodes / pathology
  • Magnetic Resonance Imaging
  • Male
  • Mediastinum
  • Middle Aged
  • Molecular Targeted Therapy
  • Neoplasm Recurrence, Local / drug therapy*
  • Oropharyngeal Neoplasms / diagnostic imaging
  • Oropharyngeal Neoplasms / drug therapy*
  • Oropharyngeal Neoplasms / metabolism
  • Oropharyngeal Neoplasms / pathology
  • Positron Emission Tomography Computed Tomography
  • Precision Medicine*
  • Radiotherapy, Intensity-Modulated
  • Receptor, ErbB-2 / metabolism
  • Taxoids / administration & dosage
  • Tomography, X-Ray Computed
  • Trastuzumab / therapeutic use*


  • Antineoplastic Agents
  • Taxoids
  • Docetaxel
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Trastuzumab
  • Cetuximab
  • Cisplatin
  • Fluorouracil