Tracking the Molecular Fingerprint of Head and Neck Cancer for Recurrence Detection in Liquid Biopsies

Abstract

The 5-year relative survival for patients with head and neck cancer, the seventh most common form of cancer worldwide, was reported as 67% in developed countries in the second decade of the new millennium. Although surgery, radiotherapy, chemotherapy, or combined treatment often elicits an initial satisfactory response, relapses are frequently observed within two years. Current surveillance methods, including clinical exams and imaging evaluations, have not unambiguously demonstrated a survival benefit, most probably due to a lack of sensitivity in detecting very early recurrence. Recently, liquid biopsy monitoring of the molecular fingerprint of head and neck squamous cell carcinoma has been proposed and investigated as a strategy for longitudinal patient care. These innovative methods offer rapid, safe, and highly informative genetic analysis that can identify small tumors not yet visible by advanced imaging techniques, thus potentially shortening the time to treatment and improving survival outcomes. In this review, we provide insights into the available evidence that the molecular tumor fingerprint can be used in the surveillance of head and neck squamous cell carcinoma. Challenges to overcome, prior to clinical implementation, are also discussed.

Recommendation for imaging follow‐up strategy based on time‐specific disease failure for nasopharyngeal carcinoma

“…[25][26][27] This finding is in accordance with our conclusion that a post-EBV-DNA-positive status is a risk factor for DFS. Due to the limitations of the sensitivity of imaging in detecting early recurrence, 9 the suggestions from the conclusion of this study should be combined with EBV-DNA testing to improve the sensitivity of the imaging. Therefore, we recommend all patients undergo EBV-DNA testing during routine follow-ups.…”

“…Nevertheless, a lack of consensus on the optimal surveillance strategies remains. Currently, follow‐up for NPC is still based on expert recommendations, which lack evidence‐based medical support, and practices vary widely between clinicians and research institutions, which increases patients' confusion 9 . Imaging is an important method for monitoring distant metastasis and recurrence.…”

“…Currently, follow-up for NPC is still based on expert recommendations, which lack evidence-based medical support, and practices vary widely between clinicians and research institutions, which increases patients' confusion. 9 Imaging is an important method for monitoring distant metastasis and recurrence. However, clinical practice guidelines for most cancer types advise against routine imaging.…”

MiRNA-21–5p as a biomarker in EBV-associated oropharyngeal cancer

“…One of the neoplasms located in the area of the head and neck is oropharyngeal cancer, the vast majority of which is squamous cell carcinoma [5,6,7,8]. Given the complexity of the molecular mechanism of oropharyngeal squamous cell carcinoma (OPSCC), many studies have concentrated on coding and non-coding genes [9,10,11,12]. Biomarkers such as microRNAs (miRNAs) have recently become the focus of attention due to correlations between expression levels and specific tumors [13,14].…”

“…In individuals with head and neck cancer, increased expression of MIR21 is linked to a worse prognosis. Many essential target genes for tumor progression are regulated by miR-21 [9,13,18,21,22]. Differential expression of MIR21 has been found in cancers associated with viral infections in several studies.…”