Micro-RNAs, the Cornerstones of the Future of Radiobiology in Head and Neck Cancers?

Abstract

Even though it is only the 6th most common malignancy at the modal level, head and neck cancers are distinguished by a considerable treatment failure rate, especially by locoregional recurrences, the intrinsic tumor radioresistance being one of the causes of this phenomenon. The efforts of radiobiological research of these cancers are oriented towards the identification of biomarkers associated with radioresistance and radiosensitivity in order to modulate the treatment so that the therapeutic benefit is maximum. Micro-RNAs (miRNAs, miRs), small single-stranded non-coding RNA molecules are currently being extensively evaluated as potential biomarkers in numerous diseases, including cancer. The evaluation of the potential of miRNAs to modulate or predict radiosensitivity or radioresistance, to anticipate the risk of recurrence and metastasis, and to differentiate different tumor subtypes is based on multiple mechanisms by which mRNAs control proliferation and apoptosis and interact with cell cycle phases or act as oncogenes with the potential to influence invasion promotion or tumor suppression. A refinement of radiosensitivity based on miRNAs with clinical and radiobiological application in head and neck cancers can lead to a personalization of radiotherapy. Thus, a miRNA signature can anticipate the risk of toxicity associated with chemoradiation, the possibility of obtaining locoregional control after treatment, and the recurrence and distant metastasis risk. The potential of miRNAs as an intrinsic predictor of sensitivity to chemotherapy may also guide the therapeutic decision toward choosing an escalation or de-escalation of concurrent or sequential systemic treatment. The choice of the irradiated dose, the fractional dose, the fractionation scheme, and the refining of the dose-volume constraints depending on the radiosensitivity of each tissue type estimated on a case-by-case basis by miRNAs profile are possible concepts for the future radiotherapy and radiobiology of head and neck cancers.

Elevated pretreatment lactate dehydrogenase and albumin-to-alkaline phosphatase ratio predict poor prognosis and early treatment discontinuation in head and neck cancer patients with preexistent diabetes mellitus

“…However, the use of antidiabetic medications (metformin) can have beneficial effects by inhibiting tumor metabolic pathways. The biomarker role of LDH and AAPR in HNSCC patients with DM has been less evaluated (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13).…”

MicroRNA-4776-5p acts as a radiosensitizer and predicts the prognosis of patients with head and neck cancer receiving radiotherapy

“…MiRNA modulation of the tumor response to ionizing radiation has been reported in several studies (10,11). Growing evidence focuses only on HNCs (12). However, most miRNAs were identi ed using microarray methods, and few predict the prognosis of clinical patients.…”

Immunotherapy with PD-1 Inhibitor Nivolumab in Recurrent/Metastatic Platinum Refractory Head and Neck Cancers—Early Experiences from Romania and Literature Review

“…Scientists are currently seeking to identify predictive biomarkers for such favorable responses to immunotherapy as head and neck tumors known to promote a highly immunosuppressive tumor microenvironment (TME). Programmed death ligand-1 (PD-L1), combined positive score (CPS), tumor mutation burden (TMB), and neutrophil-to-lymphocyte ratio (NLR) are being evaluated individually or in complex models to stratify HNSCC patients and identify who would benefit the most from ICI [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 ]. Concurrently, radiomics, a new field of research based on artificial intelligence applied to medical imaging, promises to contribute meaningfully to this endeavor [ 4 ].…”