<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2340-9894</journal-id>
<journal-title><![CDATA[Ars Pharmaceutica (Internet)]]></journal-title>
<abbrev-journal-title><![CDATA[Ars Pharm]]></abbrev-journal-title>
<issn>2340-9894</issn>
<publisher>
<publisher-name><![CDATA[Universidad de Granada]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2340-98942021000400389</article-id>
<article-id pub-id-type="doi">10.30827/ars.v62i4.20980</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Resistencia a los anticuerpos monoclonales anti-EGFR en el tratamiento del carcinoma de cabeza y cuello]]></article-title>
<article-title xml:lang="en"><![CDATA[Resistance to anti-EGFR monoclonal antibodies in the treatment of head and neck carcinoma]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lazo-Roblejo]]></surname>
<given-names><![CDATA[Yaily]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Morales-González]]></surname>
<given-names><![CDATA[Maraelys]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Ciencias Médicas de Santiago de Cuba  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Oriente  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<volume>62</volume>
<numero>4</numero>
<fpage>389</fpage>
<lpage>403</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S2340-98942021000400389&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S2340-98942021000400389&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S2340-98942021000400389&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción:  Los anticuerpos monoclonales dirigidos al receptor del factor de crecimiento epidérmico (EGFR) han demostrado beneficio clínico en el carcinoma de cabeza y cuello en estadios avanzados, sin embargo, a pesar de los alentadores resultados iniciales, los estudios clínicos evidencian que hay pacientes que presentan tasas de respuesta muy pobres o nulas con su uso.  Método:  Se realizó una revisión de la bibliografía científica en las fuentes especializadas Medline, Cochrane Library y Google académico sobre los mecanismos moleculares de resistencia que pueden estar involucrados en la reducción de la eficacia de los anticuerpos monoclonales cetuximab y nimotuzumab.  Resultados:  En el caso del cetuximab, se exponen los mecanismos de resistencia intrínseca y adquirida tales como: la presencia de los polimorfismos EGFR-K521 y AURKA Phe31-Ile, la activación de puntos calientes de mutaciones en PIK3CA y KRAS/HRAS, la pérdida de expresión de PTEN, las mutaciones en el dominio extracelular del EGFR, la sobreexpresión de MET e inducción de la transición epitelial-mesenquimal, así como algunos mecanismos que involucran las vías AKT/PI3K, RAS/RAF/MEK/ERK y JAK/STAT. Con respecto al nimotuzumab, la literatura refiere que los mejores resultados clínicos con su uso se han asociado con la sobreexpresión del EGFR.  Conclusiones:  Los mayores desafíos en el carcinoma de cabeza y cuello son comprender la resistencia a estas terapias e identificar biomarcadores predictivos de respuesta para la selección adecuada de los pacientes. Aunque son múltiples las propuestas de biomarcadores que se publican, requieren su validación en ensayos clínicos prospectivos para su introducción en la práctica clínica habitual. Se sugiere la necesidad de incrementar los estudios sobre los mecanismos de resistencia al nimotuzumab.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Monoclonal antibodies targeting the epidermal growth factor receptor (EGFR) have shown clinical benefit in advanced stages of head and neck carcinoma; however, despite encouraging initial results, clinical studies show that there are patients who present rates very poor or null response with its use.  Method:  A review of the scientific literature was carried out in the specialized sources Medline, Cochrane Library and academic Google on the molecular mechanisms of resistance that may be involved in reducing the efficacy of the monoclonal antibodies cetuximab and nimotuzumab.  Results:  In the case of cetuximab, the mechanisms of intrinsic and acquired resistance are exposed, such as: the presence of the EGFR-K521 and AURKA Phe31-Ile polymorphisms, the hot spots activating PIK3CA and KRAS/HRAS mutations, the loss of PTEN protein expression, mutations in the extracellular domain of EGFR, overexpression of MET and induction of epithelial-mesenchymal transition, as well as some mechanisms involving the AKT/PI3K, RAS/RAF/MEK/ERK and JAK/STAT pathways. About nimotuzumab, the literature refers that the best clinical results with its use have been associated with EGFR overexpression.  Conclusions:  The greatest challenges in head and neck carcinoma are understanding resistance to these therapies and identifying predictive biomarkers of response for proper patient selection. Although there are multiple proposals for biomarkers that are published, they require their validation in prospective clinical trials for their introduction into routine clinical practice. The need to increase studies on the mechanisms of resistance to nimotuzumab is suggested.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[biomarcadores predictivos]]></kwd>
<kwd lng="es"><![CDATA[carcinoma de cabeza y cuello]]></kwd>
<kwd lng="es"><![CDATA[cetuximab]]></kwd>
<kwd lng="es"><![CDATA[mecanismos de resistencia]]></kwd>
<kwd lng="es"><![CDATA[nimotuzumab]]></kwd>
<kwd lng="en"><![CDATA[cetuximab]]></kwd>
<kwd lng="en"><![CDATA[head and neck carcinoma]]></kwd>
<kwd lng="en"><![CDATA[mechanisms of resistance]]></kwd>
<kwd lng="en"><![CDATA[nimotuzumab]]></kwd>
<kwd lng="en"><![CDATA[predictive biomarkers]]></kwd>
</kwd-group>
</article-meta>
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