Lessons learned from next‐generation sequencing in head and neck cancer

Scientific innovation has enabled whole exome capture and massively parallel sequencing of cancer genomes. In head and neck cancer, next‐generation sequencing has granted us further understanding of the mutational spectrum of squamous cell carcinoma. As a result of these new technologies, frequently occurring mutations were identified in NOTCH1, a gene that had not previously been implicated in head and neck cancer. The current review describes the most common mutations in head and neck cancer: TP53, NOTCH1, HRAS, PIK3CA, and CDKN2A. Emphasis is placed on the involved cellular pathways, clinical correlations, and potential therapeutic interventions. Additionally, the implications of human papillomavirus on mutation patterns are discussed. © 2012 Wiley Periodicals, Inc. Head Neck, 2013     

The role of head and neck cancer advocacy organizations during the COVID‐19 pandemic

The COVID‐19 pandemic has had a significant impact on many aspects of head and neck cancer (HNC) care. The uncertainty and stress resulting from these changes has led many patients and caregivers to turn to HNC advocacy groups for guidance and support. Here we outline some of the issues being faced by patients with HNC during the current crisis and provide examples of programs being developed by advocacy groups to address them. We also highlight the increased utilization of these organizations that has been observed as well as some of the challenges being faced by these not‐for‐profit groups as they work to serve the head and neck community.     

Clinical applications of genomics in head and neck cancer

Advances in gene expression analyses have allowed global assessment of expressed genes in clinical samples. Gene expression profiles derived from clinical specimens have been used to distinguish differences in tumors that are not obvoius by clinical, radiographic, or histologic characteristics. Despite its common histology and presentation, head and neck squamous cell carcinoma (HNSCC) is associated with widely varying clinical behavior and response to therapy. Currently, clinicians have a dearth of tools to predict response to therapy or to identify patients at high risk of poor outcome. Recently comprehensive analyses of gene expression patterns of individual tumors have shown promise to improve discovery of biomarkers for 1) progression of premalignant lesions, 2) disease presence or absence, 3) prediction of clinical outcome, and 4) identification of targets for therapy. In this review, we will discuss advances, limitations and future directions of genomics as it applies to HNSCC.     

Importance of the immune system in head and neck cancer

Head and neck squamous cell carcinoma (HNSCC) are a heterogeneous group of tumors, mainly caused by exposure to cigarette smoke and/or alcohol. In recent years, a virally driven subset of cancers driven by human papillomavirus subtype 16 [HPV‐16]) has emerged. Our own data and data from other groups have demonstrated the favorable clinical outcome of HPV‐driven oropharyngeal tumors and in both HPV+ and HPV? cancers the importance of a high density of tumor‐associated lymphocytes for survival. These data underpin manipulation and activation of the patients' immune system by treatment, and as a result immunotherapy is rapidly taking its place in the management of HNSCC. Here we review the role the immune system in relation to HNSCC and consider the implications these have for HNSCC immunotherapy. Studies to quantify survival benefits and treatment‐associated toxicities are ongoing.