Cetuximab in combination with radiotherapy is recommended as a possible treatment for people with locally advanced squamous cell cancer of the head and neck if:

  • they have a Karnofsky performance-status score of 90% or more, and
  • all forms of platinum-based chemotherapy are considered inappropriate.

Healthcare professionals should not stop prescribing cetuximab in combination with radiotherapy for people who were already receiving it when the guidance was issued, but who do not fulfil the above criteria. These patients should be able to carry on taking cetuximab until they and their healthcare professionals decide that it is the right time to stop treatment.

When assessing Karnofsky performance-status score, healthcare professionals should take into account any disabilities that might affect a person?s ability to carry out daily activities.

Your responsibility

The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.

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