Medical Oncologist
Targeted therapy
Targeted Therapy for — Head and Neck Cancer
Which targeted drug applies to your situation — if any does — depends entirely on what your tumour's molecular profile shows. Biomarker testing on your biopsy sample is the first step, and different results lead to different drugs.
Medically reviewed by Dr. Bharati Devi Gorantla, Medical Oncologist, MBBS · MD · DM (Adyar, Chennai) · ECMO · MRCP SCE (UK) · Last reviewed August 2026
- Testing comes first — Your biopsy sample is tested for specific molecular markers before any targeted treatment can be considered.
- EGFR is the most common target — Most head and neck squamous cell tumours overexpress EGFR, making anti-EGFR drugs the most widely used targeted option.
- Subtype changes the picture — Salivary gland and thyroid-origin head and neck tumours have different marker profiles and different drug options than squamous cancers.
- No target is also an answer — If testing finds no actionable marker, that finding guides treatment toward an approach that is more likely to help.
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Targeted therapy for head and neck cancer is decided by biomarker testing on your tumour sample. The markers most commonly checked include EGFR, HER2, NTRK fusions, and BRAF. NCCN and ESMO guidance recommends this testing before treatment decisions are made, because different markers lead to different drugs.
Which mutations and markers are tested in head and neck cancer?
- EGFR (Epidermal Growth Factor Receptor)
- A protein overexpressed on the surface of most head and neck squamous cell tumours. Anti-EGFR drugs, including cetuximab, target this protein and are included in NCCN and ESMO guidelines for squamous head and neck cancers.
- HER2
- A receptor protein amplified in a subset of salivary gland cancers, particularly salivary duct carcinoma. HER2-targeted drugs are more relevant here than in squamous head and neck cancers, and testing is routine for salivary gland subtypes.
- NTRK fusion
- A gene rearrangement that drives tumour growth in a small number of head and neck tumours. Larotrectinib and entrectinib are approved for any solid tumour carrying an NTRK fusion, regardless of where in the body the cancer started.
- BRAF V600E mutation
- A change in the BRAF gene found more commonly in thyroid-origin head and neck tumours than in squamous cancers. Where this mutation is confirmed, BRAF-targeted drug combinations are an option.
- RET alteration
- A mutation or gene rearrangement in the RET gene, relevant mainly in medullary and papillary thyroid cancers presenting as head and neck tumours. Targeted drugs including selpercatinib and pralsetinib are approved for RET-altered thyroid cancers.
- PIK3CA mutation
- A mutation in a growth-signalling pathway found in a proportion of squamous head and neck tumours. No targeted drug is currently approved for this mutation in head and neck cancer; clinical trials are ongoing.
Which targeted drug follows from each marker?
Cetuximab, an anti-EGFR monoclonal antibody, is the most established targeted drug in head and neck squamous cell carcinoma. NCCN and ESMO guidelines include it alongside radiation for locally advanced disease, and alongside platinum-based chemotherapy for recurrent or metastatic disease.
For HER2-amplified salivary gland tumours, HER2-directed treatment is considered. The specific drugs depend on the HER2 result and your oncologist's assessment, and the approach draws on experience from HER2-positive cancers in other sites.
If molecular testing finds an NTRK fusion, larotrectinib or entrectinib may be considered regardless of where in the head and neck the tumour started. BRAF V600E-mutated thyroid tumours may be treated with the dabrafenib and trametinib combination. RET-altered thyroid cancers — whether from a mutation or a fusion — may respond to selpercatinib or pralsetinib.
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Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Interventional Radiologist
Dr. Mohammed Imran
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
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How is biomarker testing done for head and neck cancer?
Testing is done on tissue from your biopsy — usually the sample you have already had. The laboratory examines the tumour cells for molecular changes that predict which treatments are most likely to help.
For squamous cancers, EGFR assessment is routine. For salivary gland tumours, HER2 testing is standard. NTRK, BRAF, and RET testing may be added depending on your cancer type, or as part of a broader molecular panel. Results usually take one to two weeks.
If the original biopsy sample is too small or the tissue is degraded, a repeat biopsy or a liquid biopsy may be needed before the picture is complete.
What does targeted therapy for head and neck cancer actually involve?
Cetuximab is given by intravenous infusion, usually alongside radiation or chemotherapy cycles. Oral targeted drugs — those used for BRAF, RET, or NTRK alterations — are taken as tablets at home on a schedule your oncologist will explain.
Side effects differ from chemotherapy. A skin rash is common with cetuximab and often indicates the drug is active. Oral targeted agents can cause fatigue, joint pain, or changes in blood pressure. Your team will monitor you throughout treatment.
At CION, intravenous targeted therapy is given as day care. You attend for the infusion and go home the same day.
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Common questions
Frequently asked questions
Does everyone with head and neck cancer need biomarker testing?
Not every patient will have the same panel of tests, but biomarker testing is recommended before treatment decisions are made for most head and neck cancers. Which markers are checked depends on your cancer subtype — a squamous carcinoma of the throat is tested differently from a salivary duct carcinoma or a thyroid tumour. Ask your oncologist which tests have been ordered on your sample and when results are expected.
What happens if my tumour has no actionable marker?
If testing finds no actionable marker, it does not mean you have run out of options — it means targeted therapy is unlikely to help, and a different approach is recommended. For squamous head and neck cancers, options may include radiation, surgery, chemotherapy, or immunotherapy depending on the stage and location. Your oncologist will explain which applies to your situation and what it is intended to achieve.
Is cetuximab the same as immunotherapy?
No. Cetuximab is a targeted therapy that blocks the EGFR protein on the surface of tumour cells. Immunotherapy works differently — it removes the brakes on your own immune system rather than blocking a specific tumour protein. Both can be used in head and neck cancer, but they act through different mechanisms and are recommended in different settings. Your oncologist will explain which approach, or which combination, applies to your diagnosis.
How is targeted therapy given, and how often?
This depends on which drug you are receiving. Cetuximab is an intravenous infusion given on a schedule alongside radiation or chemotherapy. Oral targeted drugs — for BRAF, RET, or NTRK alterations — are taken as tablets at home. Your oncologist will explain the schedule before you start, how long treatment is planned to continue, and what blood tests or scans are needed during it.
What side effects should I expect from targeted therapy for head and neck cancer?
Side effects depend on which drug you are taking and are different from those of chemotherapy. Cetuximab commonly causes a skin rash that can sometimes be significant enough to need treatment in its own right; it does not typically cause hair loss or the same pattern of nausea that chemotherapy does. Oral targeted agents can cause fatigue, joint pain, raised blood pressure, or other effects depending on the specific drug. Your team will tell you what to watch for before treatment begins.
Is targeted therapy for head and neck cancer available at CION?
Yes. Intravenous targeted therapies, including cetuximab, are given as day care at CION centres — you attend for the infusion and return home the same day. Oral targeted drugs are prescribed for home use. Molecular testing to establish eligibility is coordinated through appropriate laboratories. CION does not provide CAR-T or cell therapy; if that is being considered as part of your treatment, you would be referred to a centre that offers it.