Abstract. Oral cancer is aggressive and invasive. The 5-year survival rate is around 50% and has not improved in over 50 years. One-third of oral cancer patients develop local and/or regional tumor recurrence following treatment. We continue to use our multicellular spheroid (MCS) model to better understand how the extracellular matrix contributes to epithelial to mesenchymal transition and how hypoxia contributes to the progression of oral squamous cell carcinoma (SCC).Oral cancer is the sixth most common type of cancer in the world. In the United States, 37,000 new cases are diagnosed annually and each year 8,000 individuals die from this disease (1). Squamous cell carcinoma (SCC) makes up 96% of all oral cancers (2). Despite advances in treatment, the prognosis for oral SCC has not improved in over 50 years.The 5-year survival rate for oral SCC is approximately 50% (3). The poor prognosis of SCC is due to invasion and local recurrence. Interactions between primary SCC cells and the surrounding extracellular matrix (ECM) facilitate invasion. As a tumor grows its available resources, including oxygen availability, become extremely limited which may affect tumor cell behavior. In this study, we aimed to determine the effect of hypoxia on EMT in OSCC spheroids.SCC cells undergo a transformative process known as epithelial-mesenchymal transition (EMT). EMT is a process by which epithelial cells lose their cell polarity, decrease cellcell adhesion, and gain migratory and invasive properties. EMT involves changes in expression, distribution, and function of a number of proteins for cells to transition between the epithelial and mesenchymal phenotype. During EMT, Ecadherin expression is lost; thereby disrupting desmosomes, promoting invasion and de-differentiation (4). N-cadherin acquisition also promotes invasive SCC behavior (4,5).Previous studies show that the ιvβ6 integrin, an epithelial specific integrin, is instrumental to EMT in colorectal and oral cancer (6, 7). The ιvβ6 integrin is an epithelial-specific adhesion receptor normally not expressed in oral keratinocytes. However, upon wounding or neoplastic transformation, ιvβ6 is highly expressed by the same keratinocytes. The ιvβ6 integrin is an adhesion receptor for fibronectin (FN) and tenascin-C, and also activates TGFβ1 (8, 9). Binding of ιvβ6 integrin to FN results in the activation of FYN kinase in oral SCC. The activation of FYN kinase promotes activation of RAF/MAPK which induces EMT (10). Our laboratory demonstrated that expression of the full-length β6 subunit is required for maintenance of the mesenchymal phenotype thus promoting EMT (7).Keratins are the major structural components of the epithelial cell cytoskeleton and play a strategic role in their architectural integrity (11). It has been shown that gene mutations in keratin are responsible for a large number of inherited skin disorders thus, reinforcing their role in structural integrity of the epithelium (11). In addition to cytoskeletal changes, it is a common process for the ECM to undergo a...