Chemoprevention of Head and Neck Cancer

Abstract

728Increasing emphasis has been placed on chemoprevention as understanding of the genetic and molecular events of carcinogenesis has evolved. More than 1000 compounds that inhibit cancer development in vitro or in animal models have been identified, and active research is under way to determine which of these agents will be both effective and nontoxic in human beings. Currently, 13-cis-retinoic acid is the most studied chemopreventive agent against head and neck cancers. Unfortunately, this vitamin A derivative has significant clinical toxicity, which limits its utility in a practice setting. The efficacy of the retinoids, however, has stimulated efforts to find other chemopreventive compounds that are both effective and nontoxic. This review discusses head and neck premalignancy, chemoprevention strategies, retinoids, and several other classes of chemopreventive agents with potential efficacy against head and neck premalignancy.

The Role of COX-2 in Oral Cancer Development, and Chemoprevention/ Treatment of Oral Cancer by Selective COX-2 Inhibitors

“…After the entire epithelial surface at risk is exposed to repeated insult by carcinogens, such as tobacco, oral cancer typically emerges as a result of those carcinogenic processes. This fact strongly supports the rationale for chemoprevention [66][67][68]. There have been a number of clinical trials to show effectiveness of chemoprevention for oral premalignant lesions [69,70].…”

Activation of vocal fold healing with topical vitamin A in rabbits

“…Retinoic acid is a well-known compound used to treat leukoplakia and premalignant lesions in the oral cavity [13]. Topical administration of retinoic acid to mucous membranes results in its accumulation in target cells and regulation of cellular proliferation and differentiation of epithelial tissues.…”

Pulsed‐Dye Laser and Retinoic Acid Delay Progression of Oral Squamous Cell Carcinoma: A Murine Model

“…Retinoic acid has been clearly demonstrated to be efficacious not only for retarding the growth of oral leukoplakia but also in decreasing the incidence of second primary tumors. 9 However, despite the success of retinoic acid, it was found that, once the drug was discontinued, the lesions had the potential to return. 9 Further, there are limiting toxicities of retinoic acid which make lifelong compliance difficult to ensure.…”

“… 9 However, despite the success of retinoic acid, it was found that, once the drug was discontinued, the lesions had the potential to return. 9 Further, there are limiting toxicities of retinoic acid which make lifelong compliance difficult to ensure. 9 Dry skin, conjunctivitis, mucositis, and appetite loss are a few of the more significant toxicities.…”

“… 9 Further, there are limiting toxicities of retinoic acid which make lifelong compliance difficult to ensure. 9 Dry skin, conjunctivitis, mucositis, and appetite loss are a few of the more significant toxicities. 1,4,5,9 Nevertheless, for head and neck cancers, retinoic acid remains the most studied and efficacious chemopreventive agent, and is currently the gold standard to which all other promising alternatives should be compared.…”