Early detection and personalized treatment in oral cancer: the impact of omics approaches
Ribeiro et al. Molecular Cytogenetics
Early detection and personalized treatment in oral cancer: the impact of omics approaches
Ilda Patrícia Ribeiro 0 1
Leonor Barroso
Francisco Marques
Joana Barbosa Melo 0 1
Isabel Marques Carreira 0 1
0 CIMAGO - Center of Investigation on Environment Genetics and Oncobiology - Faculty of Medicine, University of Coimbra , Coimbra 3000-354 , Portugal
1 Cytogenetics and Genomics Laboratory, Faculty of Medicine, University of Coimbra, Polo Ciências da Saúde , Coimbra 3000-354 , Portugal
Background: Oral cancer is one of the most common malignant lesions of the head and neck. This cancer is an aggressive and lethal disease with no significant improvements in the overall survival in the last decades. Moreover, the incidence of oral HPV-positive tumors is rising, especially in young people. This oral neoplasm develops through numerous molecular imbalances that affect key genes and signaling pathways; however, the molecular mechanisms involved in the pathogenesis and progression of oral tumors are still to be fully determined. In order to improve the quality of life and long-term survival rate of these patients, it is vital to establish accurate biomarkers that help in the early diagnosis, prognosis and development of target treatments. Such biomarkers may possibly allow for selection of patients that will benefit from each therapy modality, helping in the optimization of intensity and sequence of the treatments in order to decrease side effects and improve survival. Conclusion: In this review we discuss the current knowledge of oral cancer and the potential role of omics approaches to identify molecular biomarkers in the improvement of early diagnosis, treatment and prognosis. The pursuit to improve the quality of life and decrease mortality rates of the oral patients needs to be centralized on the identification of critical genes in oral carcinogenesis. Understanding the molecular biology of oral cancer is vital for search new therapies, being the molecular-targeted therapies the most promising treatment for these patients.
Oral cancer; Early diagnosis; Omics data; Molecular biomarkers; Molecular profiling
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Background
Oral cancer is part of a group of cancers named head
and neck cancer (HNC), which enclose a wide set of
diverse tumor types arising from various anatomic
structures, such as oral cavity, oropharynx, larynx,
hypopharynx and nasopharynx. Histopathologically,
squamous cell carcinomas (SCCs) represent nearly 90% of all
these tumors and over 50% arise in the oral cavity [1]. The
most significant and well-established risk factors related to
this neoplasm are tobacco use (smoked or chewed),
excessive alcohol consumption and/or human papilomavirus
(HPV) infection. HPV genomic DNA is present in
almost 25% of oral squamous cell carcinomas (OSCCs)
[2, 3] and patients with HPV-positive oropharyngeal
tumors have a better prognosis compared with
HPVnegative oropharyngeal patients, although the reasons
for this are not yet complete clarified [4]. It could be
related to the more frequent HPV positivity in
individuals having no other risk factors and to their usually
different histology (poorly differentiated, basaloid) [2].
Worldwide, oral and pharyngeal tumors, when
combined, represent the sixth most common cancer, with
more than 300,000 estimated new cases and approximately
145,000 deaths from oral cavity cancer (including lip
cancer) in 2012 [5]. Furthermore, it is estimated that its
incidence will raise due to population growth, aging
and the adoption of a lifestyle associated to cancer-risk
factors [6]. It is interesting to note that two types of
behavior and wariness have apparently contributed in
opposite ways: in one way a slight decrease has been
observed in the overall incidence of these tumors in the
past two decades [2], which is most probably associated
© The Author(s). 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
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with a reduction in the prevalence of smoking [7]; on
the other hand, an increase has been detected especially
in oropharyngeal cancers (base of tongue and tonsillar)
[8], which can be associated with the increase in oral
and oropharyngeal HPV infections [7, 9]. Since oral
cancer has been more common in men than in women
HPV vaccination for both genders should be an option
to be considered regarding HNC prevention, but
further studies are needed to determine the efficacy and
cost-benefit of this kind of vaccin (...truncated)