Indian oncologists view that targeted therapeutics and monoclonal antibodies (MAbs) would dominate the head & neck cancer treatment space owing to their superior efficacy and safety. The observation came in during head and neck cancer month observed between April 1-30, 2014.

In India, due to economic and social problems, 60-80 per cent of patients present advanced disease condition as compared to 40 per cent those from the developed countries making it further complex to treat. Lack of awareness, ignorance about clinical trials, poor access to diagnosis and treatment and  poor insurance penetration are a concerns for clinicians.

The incidence of head & neck cancers increases with age, though the pattern may differ with different risk factors. Predominantly, adults above age 45 are at higher risk. Increasingly younger people with H&N cancer are being seen in India.

“This is where targeted therapeutics & MABs along with  definitive genetic testing will also be available soon that can detect a large number of cancers early. PET-CT will be also available at an affordable rate that would again benefit in diagnosing and treatment. Ultimately tobacco control is important to prevent these cancers,”  Dr. Radheshyam Naik, medical oncologist, HCG told Pharmabiz.

Not many chemotherapy agents have evolved in the recent times to tackle this complex disease. However, Nimotuzumab or BIOMAb,  an indigenous anti-EGFR monoclonal antibody that targets the EGFR receptors which are over-expressed in 80-95 per cent of head & neck cancers. The  drug  developed by Biocon Limited is gaining high acceptance among oncologists considering the efficacy and quality of life it offers to the patients. In combination with chemotherapy and radiation therapy Nimotuzumab  or BIOMAb has improved efficacy in these patients, he added.

Tobacco is one of the major risk factors in India and results from global tobacco survey depicted that about 15-20 per cent of children below 15 years of age are addicted to this in some form. This is further augmented by the paucity of specialists  adding to the constraints the timely treatment, noted the cancer experts.

In India, head and neck cancers have a  distinct demographic profile, risk factors, food habits, and family history. Head and neck accounts to 32 per cent of total cancers, and 60 per cent of global Head & Neck cancers occur in Asia especially India. Non  tobacco related H&N cancer is also increasing probably related to Human papillomavirus (HPV).

A slow decline in overall incidence has been documented  considering the improved patient care, better therapeutics and availability of best in class equipment. On the other hand, the incidence of head & neck is slowly increasing in women, due to increased usage of tobacco, where as it is decreasing in men, said Dr Naik.