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Oral Cancer

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Genomics, Personalized Medicine and Oral Disease

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Abstract

Among a wide variety of human oral cancers, the most significant in terms of overall morbidity and mortality is squamous cell carcinoma of the head and neck (HNSCC). Until very recently the molecular pathogenesis of HNSCC was unknown, and few therapeutic options were available outside of surgery, standard cytotoxic chemotherapy and radiation. Recent epidemiologic and clinical studies have revealed two subsets of HNSCC, human papilloma virus (HPV)-associated and non HPV-associated disease, characterized by distinct pathogenesis, natural history, and prognosis. The latter is a carcinogen-induced tumor associated with high levels of genomic aberrations and presumed genomic instability, while the former is a virally-induced cancer that exhibits relatively fewer mutations. Classical oncogene mutations including PIK3CA and RAS are observed in both subsets of HNSCC but are relatively uncommon. Instead, numerous tumor suppressor pathways are commonly inactivated including p53, Rb/CDKN2A, NOTCH, and TGFβ/SMAD, as are a host of epigenetic regulatory enzymes. Deregulation of these genetic pathways alters key cellular processes within the stratified squamous epithelium including proliferation, terminal differentiation, cell survival, and adhesion and migration. Understanding how these factors and pathways interact in tumor progression will undoubtedly improve disease classification and prognostication, ultimately providing the foundation for new, more selective and effective therapeutic approaches.

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Authors and Affiliations

  1. Massachusetts General Hospital Cancer Center and Harvard Medical School, GRJ-904, 55 Fruit Street, 02114, Boston, MA, USA

    Srinivas Vinod Saladi Ph.D. & Leif W. Ellisen M.D., Ph.D.

Authors
  1. Srinivas Vinod Saladi Ph.D.
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  2. Leif W. Ellisen M.D., Ph.D.
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Correspondence to Leif W. Ellisen M.D., Ph.D. .

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Editors and Affiliations

  1. Brigham and Women’s Hospital, Boston, Massachusetts, USA

    Stephen T. Sonis, DMD, DMSc

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© 2015 Springer International Publishing Switzerland

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Saladi, S., Ellisen, L. (2015). Oral Cancer. In: Sonis, DMD, DMSc, S. (eds) Genomics, Personalized Medicine and Oral Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-17942-1_13

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