Abstract
This chapter focuses on personalized medicine for oral cancer, with emphasis on selection of current and future therapies. Specifically, treatment selection of radiation, chemotherapy, and surgery and customized strategies for selection of targeted therapy are discussed. Worldwide, head and neck cancer is the sixth most common cancer by incidence and the fifth most common cause of cancer-related deaths. More than 90 % of oral cancers are squamous cell carcinomas (SCCs), which are the focus of this chapter. SCC arises from the oral cavity including lip, oropharynx/tonsil, larynx, and hypopharynx. The risk factors for SCC are tobacco, alcohol, and human papillomavirus 16 (HPV16). HPV-positive SCC usually occurs in the oropharynx, and HPV-negative SCC usually occurs in the oral cavity, larynx, and hypopharynx. Personalized medicine is customization of treatment to the individual patient. The goals of personalized medicine are to improve clinical outcome, reduce side effects, and decrease expenses. Currently personalized medicine in oral cancer is based on tumor stage and location, but not tumor biology. Unfortunately, two patients with similar tumor stage may respond differently to the same therapy. Identification at the time of diagnosis of an early-stage lesion that will behave aggressively will facilitate selection of appropriate aggressive treatment at the time of initial diagnosis. However, aggressive treatment is not appropriate for all early-stage lesions due to toxicity of treatment. Although targeted treatment has been developed for SCC, it is not used in a customized approach. This chapter discusses evolving approaches to customize therapy based on the biology of the individual tumor. Furthermore, targeted therapy and potential biomarkers to match therapy to patients are also discussed.
Published Version
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