Biomarker driven treatment of head and neck squamous cell cancer

Abstract

Treatment modalities of head and neck squamous cell cancer include surgery, radiation, chemotherapy, targeted agents and immune checkpoint inhibition. Treatment is often toxic and can affect long-term function and quality of life. In this context, identification of biomarker data that can help tailor therapy on an individualized basis and reduce treatment-related toxicity would be highly beneficial. A variety of predictive biomarkers have been discovered and are already utilized in clinical practice, while many more are being explored. We will review p16 overexpression as a surrogate biomarker in HPV-associated head and neck cancer and plasma EBV DNA as a biomarker in nasopharyngeal carcinoma, the two established biomarkers currently utilized in clinical practice. We will also examine novel predictive biomarkers that are in clinical development and may shape the future landscape of targeted head and neck cancer therapy. These emerging biomarkers include the tyrosine kinases and their signaling pathway, immune checkpoint biomarkers, tumor suppressor abnormalities, and molecular predictors of hypoxia-targeted therapy. We will also look at futuristic biomarkers including detection of circulating DNA from clinical specimens and rapid tumor profiling. We will highlight the ongoing effort that will see a shift from prognostic to predictive biomarker development in head and neck cancer with the goal of delivering individualized cancer therapy. Trial registration: N/A.

Combined CT radiomics of primary tumor and metastatic lymph nodes improves prediction of loco-regional control in head and neck cancer

“…Due to the heterogeneous nature of this disease, the cure rates at 5 years after RCT vary from 50% to 80% 4,5 . In the era of precision medicine, various prognostic biomarkers, such as gene mutation, serum biomarkers and tumor hypoxia have been proposed to improve patient stratification and to consequently increase treatment response by treatment intensification in bad-performing subgroups and reduce side effects by treatment deintensification in well-performing subgroups 6–8 .…”

Tissue and serum expression of TGM-3 may be prognostic marker in patients of oral squamous cell carcinoma undergoing chemo-radiotherapy

“…The 5- year survival of 50%, has remained disappointingly stable over the last few decades in spite of improvements in the main treatments of surgery and radiotherapy [ 2 – 4 ]. These treatments are often toxic and can affect long term functioning and quality of life of the patients [ 5 ]. So there is a need to identify biomarkers that are able to predict prognosis and response to treatment [ 5 ].…”

“…These treatments are often toxic and can affect long term functioning and quality of life of the patients [ 5 ]. So there is a need to identify biomarkers that are able to predict prognosis and response to treatment [ 5 ]. The most informative marker is node status, N-status, where cervical lymph node involvement drastically worsens the prognosis.…”

“…More than 30% of patients eventually develop local recurrence or metastasis usually within the first 2 year of follow-up and completion of treatment [ 6 ]. Identification of biomarker can help tailor therapy on an individual basis and reduce treatment–related toxicity [ 5 ].…”

Extracellular miRNAs as Biomarkers of Head and Neck Cancer Progression and Metastasis

“…One such marker already established in everyday routine is HPV status. It is, however, only useful in cases of oropharyngeal cancer, where it is associated with a better prognosis due to the increased radiosensitivity of HPV-associated tumors [33]. Recent efforts have therefore been focused on finding more universal and easily accessible prognostic and predictive biomarkers that would drive therapeutic choices in HNSCC and lead to overall survival improvement, such as extracellular miRNAs.…”