Biological therapies use substances that are produced naturally in the body, to destroy cancer cells. There are several types of biological therapy that may be used to treat head and neck cancers. These include monoclonal antibodies and cancer growth inhibitors. Biological therapies are mainly given as part of cancer research trials.

Monoclonal antibodies are drugs that recognise and attach to specific proteins (receptors) that are found in particular cancer cells or in the blood stream.

Some cancer cells have receptors known as epidermal growth factor receptors (EGFR). When growth factors attach to the receptor, the cancer cell is stimulated to grow and divide. The monoclonal antibody cetuximab (Erbitux®) locks onto the EGFR and may prevent the cancer cell from growing and dividing. It may also make the cancer cells more sensitive to the effects of radiotherapy.

Cetuximab is sometimes used, in combination with radiotherapy, to treat squamous-cell head and neck cancers that have begun to spread into surrounding tissues (locally advanced cancer). It is given as a drip (infusion) into a vein.

The National Institute for Health and Clinical Excellence (NICE), which advises doctors about treatment, is awaiting more information on the cost-effectiveness of cetuximab before it recommends it in combination with radiotherapy, in the treatment of people with locally advanced head and neck cancers. As a result it may not be possible to get cetuximab on the NHS, without taking part in a clinical trial.

In order to grow and divide, cancer cells ‘communicate’ with each other using chemical signals. Cancer growth inhibitors interfere with this process and so affect the cancer’s ability to develop. A cancer growth inhibitor called gefitinib (Iressa®) is being used as part of trials to treat some types of head and neck cancer that have come back after initial treatment.