The role of personalized medicine in Head and Neck cancer

Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers worldwide associated with one-tenth cause of mortality and morbidity in our country. In spite of the prevalence of this cancer in elderly, over use of cigarette and hookah during the past decade compare to two decades ago it has been more diagnosed in 30-40 ages. Since oral cancer could be treated easily by early diagnosis, oral premalignant lesions (OPL) detection such as leukoplakia could be helpful as an accessible prognosis of malignant to determine diagnostic tests and targeted treatment. Poor value of pathological factors in predicts of OL transformation and high frequency of clinical heterogeneity leads us to personalize medicine and develop molecular-based strategies and biomarkers in tumor gene expression signature in 3 levels: Genome, Transcriptome and Proteome. Oral cavity is a complex anatomical site critical for speech, swallowing and appearance so surgery is pivotal in this cancer so it provides small size of margin to access large gene panel and find the correlation between molecular profile and metastasis. In treatment field we categorize patients due to expose with microenvironment such as tobacco, alcohol and also HPV virus or not. For instance HPV positive is associated with a higher radiosensitivity thought to be linked to P16 overexpression so radiotherapy would be the targeted therapy. As a consequence a comprehensive review from histopathology to molecular expression analyze head us to precision medicine which particularly relevant in this disease.

کلیدواژه ها:

Head and neck squamous cell carcinoma ، Oral premalignant lesions ، Clinical heterogeneity ، Gene expression signature