Update on Head and Neck Cancer: Current Knowledge on Epidemiology, Risk Factors, Molecular Features and Novel Therapies

Abstract

Tobacco use and alcohol consumption are the main risk factors associated with head and neck squamous cell carcinoma (SCC) development due to their cytotoxic and mutagenic effects on the exposed epithelia of the upper aerodigestive tract. Epstein-Barr virus (EBV) and high-risk human papillomaviruses (HPVs), both encoding viral oncoproteins able to interfere with cell cycle control, have been recognized as the etiological agents of nasopharynx carcinoma and a fraction of oropharyngeal carcinoma, respectively. Head and neck SCC is a deadly disease and despite innovative treatments represents a major challenge for patients. Recently, a number of genomic studies have highlighted the molecular heterogeneity of head and neck SCC based on methylation profiles, microRNA expression, mutated genes and new druggable pathways which may represent new targets for cancer-tailored therapies. To date, cetuximab is the only FDA-approved anti-epidermal growth factor receptor therapy for the treatment of head and neck SCC. In addition, a number of monoclonal antibodies targeting AKT, mTOR and PI3K pathways are under evaluation. Several therapeutic vaccines against HPV16 and EBV proteins are also under study. The purpose of this article is to review the epidemiology, pathogenesis and molecular features of head and neck SCC, with an emphasis on new therapies.

Recurrent CDK1 overexpression in laryngeal squamous cell carcinoma

“…Genetic data have been successfully transformed into clinical practice, for example for chronic myeloid leukemia (CML) where the application of BCR-ABL tyrosine kinase inhibitor—imatinib is widely used [34], and in case of HER2-positive breast cancer, combination of lapatynib and transtuzumab is applied for inhibition of HER2 [35]. So far, for head and neck tumors, only Cetuximab has been approved for treatment [36]. Here, we have analyzed a potential target for an inhibition therapy— CDK1 in larynx squamous cell carcinoma (LSCC) and show its overexpression in this tumor.…”

Accuracy of Diagnostic Methods for Detection of Head and Neck Primary Origin in Metastatic Neck Mass

“…Significantly impaired outcome for patients with mutated p53 status or overexpression of p53 (whose expression directly correlates with the mutated protein, as the second tends to accumulate) in HNCUP and HNSCC has been demonstrated before [72,73]. Some of the authors also examined the impact of the combined HPV/p53 status on survival and came to the conclusion that p53 could be an independent prognostic factor regardless of the HPV status [74].…”

“…NPC is much more common in southern China and southeast Asia than in Europe or north America [74]. EBVs latent membrane protein 1 is highly suspicious of having a central role in both initiation and progression of the tumor [76][77][78].…”

Human papillomavirus (HPV) infection: a Mozambique overview

“…The male/female ratio ranges from 2:1 to 15:1 and in particular, buccal mucosa and tongue cancers predominate in developing areas while in industrialized areas the pharynx cancer represent the most common form [62]. The association with HPV is very common, even if important risk factors are considered also smoking and/or alcohol consumption, and oral sex [50,2,66].…”