Oral Squamous Cell Carcinoma as a Complication of Treatment for Recurrent High‐Grade Serous Cancer

Abstract

Objectives/Hypothesis: Advances in cancer treatment have increased survival for many patients, prompting a need for greater recognition of the long-term complications of treatment. Chemotherapy agents have the potential to induce carcinogenesis and can increase the risk of secondary malignancy. Pegylated liposomal doxorubicin (PLD) used for maintenance treatment of recurrent high-grade serous cancers has been associated with the development of oral cavity squamous cell carcinoma (SCC). Study Design: Retrospective review. Methods: Cases of oral cavity SCC in patients with recurrent high-grade serous cancer treated with PLD between 1997 and 2017 at a single institution were reviewed. Results: Eight of 16 patients treated with PLD developed oral cavity SCC. The duration of PLD use ranged from 1.3 to 15 years (mean = 5.8 years) and cumulative dose ranged from 405 to 3,000 mg/m 2 (mean = 1,542 mg/m 2). Seven patients tested positive for BRCA mutations (four BRCA 1+, three BRCA 2+). No patients had a history of alcohol or tobacco use. All had early-stage oral cavity disease; five were T1N0, two were T2N0, and one had carcinoma in situ. All patients underwent surgery, and two received adjuvant radiation. Four developed locoregional recurrence requiring additional treatment. Of these, one patient died from complications of oral SCC, one developed recurrent ovarian cancer, and two had no evidence of disease of the oral cavity or ovarian cancer at the last follow-up. Conclusions: Long-term PLD therapy may be associated with the development of oral cavity SCC. A high index of suspicion and routine head and neck examination should be included in follow-up for exposed patients.

Nanoparticles for Oral Cancer Diagnosis and Therapy

“…El-Hamid et al have proposed that PEGylated liposomal doxorubicin (PLD) has exerted a higher apoptotic effect on CAL-27 cells than free doxorubicin [39]. However, although PLD has good safety, long-term use in some patients has been related to the development of OSCC or precancer lesion [40,41]. Other drugs incorporated in the liposomes include curcumin, paclitaxel, carboplatin, and cisplatin, which are also more effective to induce the apoptosis of cancer cells [42].…”

Aqueous Extract of Sparganii Rhizoma and Curcumae Rhizoma Induces Apoptosis and Inhibits Migration in Human Oral Squamous Cell Carcinoma

“…More than 350,000 new cases of OSCC are diagnosed worldwide each year, leading to approximately 177,000 deaths annually [24]. Conventional treatment strategies for OSCC currently include surgical intervention, chemotherapy, and radiation therapy; however, surgical resection is considered the primary treatment due to the resistance of OSCC to anticancer drugs [25]. Unfortunately, the 5-year overall mortality rate for OSCC patients remains high, exceeding 60% due to the significant risk of metastasis [26].…”

Review of the Role of Nanotechnology in Overcoming the Challenges Faced in Oral Cancer Diagnosis and Treatment

“…PEGylated liposomal doxorubicin (PLD) has a stronger apoptotic effect on CAL-27 cells than free doxorubicin [ 110 ]. Although PLD has a strong safety record, certain patients’ long-term usage of the drug has been linked to the emergence of OSCC or precancer lesions [ 111 , 112 ]. Curcumin, paclitaxel, carboplatin, and cisplatin are other medications included in liposomes and are similarly more effective at inducing the apoptosis of cancer cells [ 113 ].…”