Advances in nuclear medicine-based molecular imaging in head and neck squamous cell carcinoma

Abstract

Head and neck squamous cell carcinomas (HNSCCs) are often aggressive, making advanced disease very difficult to treat using contemporary modalities, such as surgery, radiation therapy, and chemotherapy. However, targeted therapy, e.g., cetuximab, an epidermal growth factor receptor inhibitor, has demonstrated survival benefit in HNSCC patients with locoregional failure or distant metastasis. Molecular imaging aims at various biomarkers used in targeted therapy, and nuclear medicine-based molecular imaging is a real-time and non-invasive modality with the potential to identify tumor in an earlier and more treatable stage, before anatomic-based imaging reveals diseases. The objective of this comprehensive review is to summarize recent advances in nuclear medicine-based molecular imaging for HNSCC focusing on several commonly radiolabeled biomarkers. The preclinical and clinical applications of these candidate imaging strategies are divided into three categories: those targeting tumor cells, tumor microenvironment, and tumor angiogenesis. This review endeavors to expand the knowledge of molecular biology of HNSCC and help realizing diagnostic potential of molecular imaging in clinical nuclear medicine.

Advances in tumor immune microenvironment of head and neck squamous cell carcinoma: A review of literature

“…[4] Although patients with the later-stage HNSCC have been treated, the 5-year survival rate for them still remains quite low, at about 40% to 50%. [5] Therefore, it is a key clue to seek an effective therapeutic target or prognostic biomarker.…”

Development of a fibroblast activation protein-targeted PET/NIR dual-modality probe and its application in head and neck cancer

“…Numerous HNSCC biomarkers, such as epidermal growth factor receptor (EGFR), fibroblast activation protein (FAP) and integrins, have been identified in this context. These biomarkers primarily located in tumor cells, within the tumor microenvironment and involved in tumor angiogenesis (Li et al, 2022). Promising nuclear medicine imaging agents targeting these relevant biomarkers (e.g., somatostatin receptor, FAP) have been developed and demonstrated superior sensitivity and specificity compared to [ 18 F]F-FDG PET in various clinical scenarios (Unterrainer et al, 2018;Chen et al, 2020;Linz et al, 2021).…”

“…FAP has emerged as a promising target for diagnosing and treating various malignant tumors (Loktev et al, 2018). The significant overexpression of FAP in cancer-associated fibroblasts (CAFs) in more than 90% of epithelial tumors, including HNCs, while being scarcely detectable in healthy adult tissues, has led to the development of PET imaging using radiolabeled FAP inhibitors (FAPIs) in the field of nuclear medicine (Hamson et al, 2014;Li et al, 2022). Compared to [ 18 F]F-FDG, FAP imaging shows good contrast and greater tumor uptake and has very low uptake in the healthy oral cavity, laryngeal mucosa, and brain.…”