Abstract

Simple SummaryHead and neck cancer is the sixth most common cancer worldwide and typically caused by smoking and alcohol consumption, or infection with Human Papillomavirus (HPV). Currently, treatment options include surgery, radiotherapy, and/or chemotherapy. However, whilst the survival rate in HPV+ cancer patients is better than those without HPV, survival rates have not improved greatly in recent years, and recurrence rates are high. Ubiquitination is a critical regulatory mechanism that can promote the activation or termination of signal cascades, such as the NFκB pathway, which plays an important role in the pathogenesis and therapeutic resistance of head and neck cancer. In this review, we discuss how NFκB signalling is regulated by ubiquitination and how the ubiquitin pathway is deregulated in head and neck cancer, highlighting how the this pathway may be targeted to inhibit NFκB signalling.Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide, with over 600,000 cases per year. The primary causes for HNSCC include smoking and alcohol consumption, with an increasing number of cases attributed to infection with Human Papillomavirus (HPV). The treatment options for HNSCC currently include surgery, radiotherapy, and/or platinum-based chemotherapeutics. Cetuximab (targeting EGFR) and Pembrolizumab (targeting PD-1) have been approved for advanced stage, recurrent, and/or metastatic HNSCC. Despite these advances, whilst HPV+ HNSCC has a 3-year overall survival (OS) rate of around 80%, the 3-year OS for HPV− HNSCC is still around 55%. Aberrant signal activation of transcription factor NFκB plays an important role in the pathogenesis and therapeutic resistance of HNSCC. As an important mediator of inflammatory signalling and the immune response to pathogens, the NFκB pathway is tightly regulated to prevent chronic inflammation, a key driver of tumorigenesis. Here, we discuss how NFκB signalling is regulated by the ubiquitin pathway and how this pathway is deregulated in HNSCC. Finally, we discuss the current strategies available to target the ubiquitin pathway and how this may offer a potential therapeutic benefit in HNSCC.

Highlights

  • Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide, with over 600,000 cases and around 300,000 deaths per year [1]

  • We discuss how NFκB signalling is regulated by the ubiquitin pathway and how this pathway is deregulated in HNSCC

  • The most common cancer associated with human papillomavirus (HPV) infection is cervical cancer, which is primarily caused by the high-risk HPV types 16 and 18 (70%) [9]; in contrast, HPV+ HNSCC is almost always due to HPV16 infection [1]

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Summary

A Potential Therapeutic Target in Head and Neck

Simple Summary: Head and neck cancer is the sixth most common cancer worldwide and typically caused by smoking and alcohol consumption, or infection with Human Papillomavirus (HPV). Treatment options include surgery, radiotherapy, and/or chemotherapy. Whilst the survival rate in HPV+ cancer patients is better than those without HPV, survival rates have not improved greatly in recent years, and recurrence rates are high. Ubiquitination is a critical regulatory mechanism that can promote the activation or termination of signal cascades, such as the NFκB pathway, which plays an important role in the pathogenesis and therapeutic resistance of head and neck cancer. We discuss how NFκB signalling is regulated by ubiquitination and how the ubiquitin pathway is deregulated in head and neck cancer, highlighting how the this pathway may be targeted to inhibit NFκB signalling

Introduction
The NFκB Signalling Pathway
Canonical NFκB Signalling
Non-Canonical
Non-Canonical NFκB Signalling
Ubiquitin-Mediated NFκB Signalling in Head and Neck Squamous Cell Carcinoma
Targeting the Ubiquitin System to Inhibit NFκB Signalling in HNSCC
Targeting the Proteasome
Targeting E1 Activating Enzymes
Targeting E2 Conjugating Enzymes
Targeting E3 Ligases
Targeting Deubiquitinase
Findings
Conclusions
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