Head and Neck Squamous Cell Carcinoma: Risk Factors, Molecular Alterations, Immunology and Peptide Vaccines

Abstract

Head and neck squamous cell carcinoma (HNSCC) arises from the epithelial lining of the oral cavity, hypopharynx, oropharynx, and larynx. There are several potential risk factors that cause the generation of HNSCC, including cigarette smoking, alcohol consumption, betel quid chewing, inadequate nutrition, poor oral hygiene, HPV and Epstein–Barr virus, and Candida albicans infections. HNSCC has causative links to both environmental factors and genetic mutations, with the latter playing a more critical role in cancer progression. These molecular changes to epithelial cells include the inactivation of cancer suppressor genes and proto-oncogenes overexpression, resulting in tumour cell proliferation and distant metastasis. HNSCC patients have impaired dendritic cell (DC) and natural killer (NK) cell functions, increased production of higher immune-suppressive molecules, loss of regulatory T cells and co-stimulatory molecules and major histocompatibility complex (MHC) class Ι molecules, lower number of lymphocyte subsets, and a poor response to antigen-presenting cells. At present, the standard treatment modalities for HNSCC patients include surgery, chemotherapy and radiotherapy, and combinatorial therapy. Despite advances in the development of novel treatment modalities over the last few decades, survival rates of HNSCC patients have not increased. To establish effective immunotherapies, a greater understanding of interactions between the immune system and HNSCC is required, and there is a particular need to develop novel therapeutic options. A therapeutic cancer vaccine has been proposed as a promising method to improve outcome by inducing a powerful adaptive immune response that leads to cancer cell elimination. Compared with other vaccines, peptide cancer vaccines are more robust and specific. In the past few years, there have been remarkable achievements in peptide-based vaccines for HNSCC patients. Here, we summarize the latest molecular alterations in HNSCC, explore the immune response to HNSCC, and discuss the latest developments in peptide-based cancer vaccine strategies. This review highlights areas for valuable future research focusing on peptide-based cancer vaccines.

Image-Guided Radiation Therapy for Squamous Cell Cancer of the Head and Neck in a Specialized Peruvian Public Hospital

“…SCCHN is treated by several modalities, including radiation, surgery, and chemotherapy. Newer approaches such as immunotherapy [ 17 ], peptide vaccines [ 18 ], nutritional management [ 19 ], pain management [ 20 ], and even adjuvant cannabis therapy [ 21 ] have been investigated to improve patient outcomes. Surgery, radiotherapy, and chemotherapy can cause swelling and displacement of anatomical structures around the treatment site, which may require changes in the radiotherapy treatment plan to achieve a good result [ 22 , 23 ].…”

A clinician’s dilemma: what should be communicated to women with oncogenic genital HPV and their partners regarding the risk of oral viral transmission?

“…Around two thirds of head and neck cancers are identified at late stages [ 9 ]. Squamous cell carcinomas occurring in the oral cavity, oropharynx, hypopharynx, and larynx mucosae constitutes over 90% of head and neck cancers [ 10 ]. Specifically, oropharyngeal squamous cell carcinomas (OPSCCs) arise in the epithelium of the crypts of the palatine and lingual tonsils, base of tongue, soft palate, and posterior wall of pharynx [ 10 ].…”

Immunotherapy in Head and Neck Cancer When, How, and Why?

“…The consumption of tobacco, alcohol, and chronic infection by the Human Papilloma Virus (HPV) are the main risk factors associated with the development of HNC [ 1 , 7 , 8 , 9 ]. Approximately 75% of HNSCC cases are associated with tobacco and alcohol consumption, inducing mutations in the tumour protein p53 gene ( TP53 ), interfering with deoxyribonucleic acid (DNA) synthesis and DNA repair mechanisms [ 1 ].…”

“…Within the different genotypes, the World Health Organization (WHO) considers HPV-16 the most frequent type associated with oropharyngeal HNSCC, exerting its carcinogenic effect through two viral oncoproteins—E6 and E7 [ 1 , 10 , 11 ]. These oncoproteins assume the ability to degrade two tumour suppressors, P53 and retinoblastoma protein (pRb), promoting uncontrolled proliferation, genomic instability, and cell cycle dysregulation [ 1 , 8 , 9 , 11 ]. Epstein–Barr (EBV) infection may also trigger cancer in the nasopharynx due to the encoding of latent membrane proteins, such as latent membrane proteins 1 and 2 (LMP1 and LMP2), contributing to the progression of HNSCC [ 12 , 13 ].…”