Abstract
Cancers of the head and neck region are among the leading causes of cancer-related mortalities worldwide. Oral leukoplakia and erythroplakia are identified as precursor lesions to malignancy. Patients cured of an initial primary head and neck cancer are also susceptible to developing second primary tumors due to cancerization of their mucosal field. Multi-step acquisition of genetic mutations leading to tumorigenesis and development of invasive cancer has been previously described. Recently, whole exome sequencing of tumor specimens has helped to identify driver mutations in this disease. For these reasons, chemoprevention or the use of systemic or biologic agents to prevent carcinogenesis is an attractive concept in head and neck cancers. Nonetheless, despite extensive clinical research in this field over the past couple decades, no standard of care option has emerged. This review article reports on targeted interventions that have been attempted in clinical trials to date, and focuses on novel molecular pathways and drugs in development that are worthy of being tested for this indication as part of future endeavors.
Highlights
Over 60,000 new cases of squamous cell cancers of the head and neck (SCCHN) will be diagnosed in the United States alone in 2017, and over 13,000 people are expected to die from their disease [1]
A combined analysis of 13 international cancer registries showed that the cumulative risk of a second primary tumor (SPT) over 20 years reaches between 30–40% with no plateauing over time, and that these most commonly develop in the aero-digestive tract [12]
Three discrete populations could potentially be candidate for these trials: (1) individuals with excessive exposure to tobacco or alcohol who are at high risk for developing SCCHN; (2) individuals with oral premalignant lesions (OPML) who harbor high-risk features of their lesions evolving into invasive cancers; and (3) patients who have been cured of an initial SCCHN
Summary
Over 60,000 new cases of squamous cell cancers of the head and neck (SCCHN) will be diagnosed in the United States alone in 2017, and over 13,000 people are expected to die from their disease [1]. The majority of SCCHN could be caused by environmental exposure to tobacco and alcohol [10]. This is believed to be a key trigger for the development of OPML and their eventual transformation into invasive cancers. Patients cured from an initial cancer are at significantly increased risk of developing a second primary tumor (SPT) [12,13]. A combined analysis of 13 international cancer registries showed that the cumulative risk of a SPT over 20 years reaches between 30–40% with no plateauing over time, and that these most commonly develop in the aero-digestive tract [12]. SPT are a major cause of increased morbidity and mortality among survivors of an initial SCCHN primary [14,15,16]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
