In patients with primary squamous cell carcinoma of the head and neck, the presence of lymph node metastasis
is considered the most important negative prognostic factor for survival. Despite advanced anatomic and
metabolic imaging techniques, in patients staged clinically and radiographically as node-negative (cN0), occult
lymph node metastasis are still present in 20-30% of patients. To address this, the current guidelines recommend
either elective regional neck dissection or sentinel lymph node biopsy. Compared to a neck dissection, minimally-
invasive sentinel lymph node biopsy minimizes surgical morbidity, cosmetic deformity, and duration of surgery.
unfortunately, the sentinel lymph node biopsy technique has not been widely adopted in head and neck cancer
because the tumors are often inaccessible and patients poorly tolerate direct tumor injections (the current
standard of care). To facilitate the adoption of this minimally-invasive technique in routine clinical practice the
United States, we propose to overcome these traditional barriers to sentinel lymph node biopsy using a
systemically delivered agents to replace locally injected agents. To this end, we propose a pilot study in head
and neck cancer patients to determine if the presence of radio- or fluorescence-labeled panitumumab correlates
with histological evidence of cancer in surgically obtained lymphadenectomy samples. If successful, our study
would be the first trial to evaluate the use of a systemic imaging agent for sentinel lymph node biopsy
identification and removal. Successful application of this technique to head and neck cancers could have
implications for other tumor types for which lymph node status plays an important role.