The actual landscape in head and neck cancer therapy

Abstract

In addition to the environmental factors
(tobacco and alcohol consumption), the
genetic risk for HNSCC has been reported to
be associated with individual susceptibility
to chemical carcinogenesis because of
gene polymorphisms of human drugmetabolizing
enzymes and DNA gene repair.
Therefore, the use of drugs that interfere with
the result of these metabolism and repair
pathways could be used in the management
of this disease, especially in HNSCC (HPV)
– negative [1].
Considering that HNSCC in advanced
stages (III and IV) are the majority without
good results, the usual therapy is the
association of chemoirradiation followed by
surgery or surgery plus or chemoirradiation
in elderly patients with co-morbidities in
spite of these neoplasias courses go to failure
and new protocols are justified [2].
HNSCCs have a large infiltration of
immune cells, although the composition of
this infiltrate and its extension vary according
to the anatomical site and the etiologic agent,
for example, smoking versus HPV. Thus,
there are several molecular signatures on
the HNSCC in distinct immune phenotypes.
These signatures incorporate several tumor
markers that can classify tumors and can be
useful in predicting therapeutic response,
particularly in checkpoint inhibitory
therapies [3].
With the advent of targeting drugs called
checkpoint modulations, the control of
apoptosis for programmed death of patients
HPV+ status, is one of the new ways to
predict the cancer evolution [4].