In 2014, Rampias et al. reported an association of HRAS mutational status with de novo resistance to cetuximab-based chemotherapy (P = 0.046) in a small HNSCC cohort (7 HRAS-mutated vs 48 wildtype patients), suggestive of HRAS-mutant-related RAS/Erk activation for cetuximab resistance in HNSCC5. This evidence concerns the gene MAPK1 and head and neck squamous cell carcinoma.