Recent Advances and Future Directions in Clinical Management of Head and Neck Squamous Cell Carcinoma

Abstract

Head and neck squamous cell carcinoma (HNSCC) is the most common cancer arising in the head and neck region. The most common risk factors are smoking, excessive drinking, and human papillomavirus (HPV) infection. While the overall incidence of smoking is decreasing, the incidence of HPV-related HNSCC is increasing in the United States and Western Europe, which led to a shift in understanding of the pathophysiology, treatment, and prognosis of this disease. The outcomes for non-metastatic HNSCC remains very encouraging and continues to improve. Advances in radiation technology and techniques, better organ preserving surgical options, and multidisciplinary treatment modalities have improved cure rates for locally advanced HNSCC patients. The treatment of metastatic disease, however, remains an area of need. The advancement of immune checkpoint inhibitors has provided significantly better outcomes, but only a small proportion of patients obtain benefits. Most recurrent and/or metastatic HNSCC patients continue to have poor survival. This has led to the vigorous investigation of new biomarkers and biomarker-based therapies. Novel therapeutic options including adaptive cellular therapy and therapeutic vaccines are also on the horizon. In this review, we highlight the latest advances in the field of HNSCC and the future direction of research.

Phytochemicals as Potential Chemopreventive and Chemotherapeutic Agents for Emerging Human Papillomavirus–Driven Head and Neck Cancer: Current Evidence and Future Prospects

“…Considering HPV-positive tumors to be immunologically active, in recent past, attempts have been made to design PD1-PDL1 immunotherapeutic strategies ( Qiao et al, 2020 ). New cancer immune-prevention treatments include FDA-approved inhibitory antibodies such as pembrolizumab (anti-PD1 mAb), nivolumab (anti-PD1), and ipilimumab (anti–CTLA-4 mAb) ( Bauman and Ferris, 2014 ; Ferris et al, 2018 ; Mehra et al, 2018 ; Havel et al, 2019 ); co-stimulation and co-inhibition pathways ( Kuss et al, 2003 ; Tsukishiro et al, 2003 ; Baruah et al, 2012 ; Pardoll, 2012 ); and check-point blockade therapy ( Davis et al, 2016 ; Muzaffar et al, 2021 ). A systematic assessment of the cost effectiveness of ICIs showed nivolumab was not cost-effective over chemotherapy for HNC ( Verma et al, 2018 ).…”

Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck: A Big and Intriguing Challenge Which May Be Resolved by Integrated Treatments Combining Locoregional and Systemic Therapies

“…Mounting evidence highlight that, in patients diagnosed with locoregionally advanced SCCHN who have been treated with upfront surgery or upfront chemoradiation, the percent of locoregional failure is about 40–50%, while distant failure is 20–30% [ 4 , 5 ].…”

Plasma cell-free circRNAs panel act as fingerprint predicts the occurrence of laryngeal squamous cell carcinoma

“…With the development of generation sequencing technology, many researchers have used omics data to predict the occurrence or prognosis of tumors. Studies have shown that the up-regulation and down-regulation of speci c gene expression in serum may be associated with clear diagnosis and prognosis of tumor [6,7].…”