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Viglianisi G, Polizzi A, Grippaudo C, Cocuzza S, Leonardi R, Isola G. Chemopreventive and Biological Strategies in the Management of Oral Potentially Malignant and Malignant Disorders. Bioengineering (Basel) 2024; 11:65. [PMID: 38247942 PMCID: PMC10813134 DOI: 10.3390/bioengineering11010065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/28/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
Oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC) represent a significant global health burden due to their potential for malignant transformation and the challenges associated with their diagnosis and treatment. Chemoprevention, an innovative approach aimed at halting or reversing the neoplastic process before full malignancy, has emerged as a promising avenue for mitigating the impact of OPMD and OSCC. The pivotal role of chemopreventive strategies is underscored by the need for effective interventions that go beyond traditional therapies. In this regard, chemopreventive agents offer a unique opportunity to intercept disease progression by targeting the molecular pathways implicated in carcinogenesis. Natural compounds, such as curcumin, green tea polyphenols, and resveratrol, exhibit anti-inflammatory, antioxidant, and anti-cancer properties that could make them potential candidates for curtailing the transformation of OPMD to OSCC. Moreover, targeted therapies directed at specific molecular alterations hold promise in disrupting the signaling cascades driving OSCC growth. Immunomodulatory agents, like immune checkpoint inhibitors, are gaining attention for their potential to harness the body's immune response against early malignancies, thus impeding OSCC advancement. Additionally, nutritional interventions and topical formulations of chemopreventive agents offer localized strategies for preventing carcinogenesis in the oral cavity. The challenge lies in optimizing these strategies for efficacy, safety, and patient compliance. This review presents an up to date on the dynamic interplay between molecular insights, clinical interventions, and the broader goal of reducing the burden of oral malignancies. As research progresses, the synergy between early diagnosis, non-invasive biomarker identification, and chemopreventive therapy is poised to reshape the landscape of OPMD and OSCC management, offering a glimpse of a future where these diseases are no longer insurmountable challenges but rather preventable and manageable conditions.
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Affiliation(s)
- Gaia Viglianisi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 68, 95124 Catania, Italy; (G.V.); (A.P.); (R.L.); (G.I.)
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 68, 95124 Catania, Italy; (G.V.); (A.P.); (R.L.); (G.I.)
| | - Cristina Grippaudo
- Head and Neck Department, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Salvatore Cocuzza
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia” ENT Section, University of Catania, Via S. Sofia 68, 95124 Catania, Italy;
| | - Rosalia Leonardi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 68, 95124 Catania, Italy; (G.V.); (A.P.); (R.L.); (G.I.)
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 68, 95124 Catania, Italy; (G.V.); (A.P.); (R.L.); (G.I.)
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Saleh MM, Darwish ZE, El Nouaem MI, Fayed NA, Mourad GM, Ramadan OR. The potential preventive effect of dietary phytochemicals In Vivo. BDJ Open 2023; 9:30. [PMID: 37463912 PMCID: PMC10353990 DOI: 10.1038/s41405-023-00157-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 06/08/2023] [Accepted: 06/30/2023] [Indexed: 07/20/2023] Open
Abstract
INTRODUCTION Chemoprevention refers to using specific substances during oncogenesis. Curcumin and catechins are both polyphenol types of phytochemicals present in curcuma longa and green tea. The effect of curcumin is synergistic with epigallocatechin gallate, the most abundant polyphenol in tea. AIM To evaluate and compares the chemopreventive effect of both green tea and curcumin (each individually and in combination) through induction of hamster buccal pouch carcinoma. MATERIALS AND METHODS Squamous cell carcinoma was chemically induced in fifty Syrian golden hamsters divided into 5 groups (10 each). The first group was used as a normal control group. The second group received the carcinogenic agent only. The other three groups received green tea, curcumin, and a combination of both, respectively. Flow cytometry, immunofluorescence, and immunohistochemical assays were used to evaluate apoptosis, proliferation, and angiogenesis. ANOVA test was used to analyze the results between the study groups. RESULTS The cells of the positive control group (B) resulted in 11.57% apoptosis. In the study groups, treatment of the cells with green tea (C), and curcumin (D) and both of them (E) showed increased apoptosis. The fluorescent image in group B showed an increase of the red fluorescence in the nucleus and cytoplasm of the squamous cell carcinoma cells while groups C, D, and E showed a decrease of the red fluorescence in the nuclei of the squamous cell carcinoma cells. The microvessel density was higher in the positive control group as compared to the treated groups. CONCLUSIONS The combination of green tea and curcumin has a significant chemopreventive effect against oral carcinogenesis.
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Affiliation(s)
- Mai M Saleh
- Lecturer Oral Pathology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Zeinab E Darwish
- Professor of Oral Pathology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Manal I El Nouaem
- Professor of Oral Pathology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Nesrin A Fayed
- Lecturer Oral Pathology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Ghada M Mourad
- Center of Excellence for Research in Regenerative Medicine and Applications (CERRMA), Faculty of Medicine, Alexandria University, Alexandria, 21521, Egypt
- Department of Histology and Cell Biology, Faculty of Medicine, Alexandria University, Alexandria, 21521, Egypt
| | - Omneya R Ramadan
- Assistant Professor of Oral Pathology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Kudva A, Kumar M, John ER, Dhara V. Occurrence of Second Oral Potentially Malignant Disorder following Excision of Primary Lesion: A Prospective Study of Cases from a Tertiary Care Centre. J Maxillofac Oral Surg 2023; 22:252-257. [PMID: 36703661 PMCID: PMC9871096 DOI: 10.1007/s12663-022-01764-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/02/2022] [Indexed: 01/29/2023] Open
Abstract
Background Early diagnosis and timely management of potentially malignant oral disorders may prevent malignant transformation and prompt diagnosis of frank malignancies favours better prognosis. The aim of this study was to evaluate the outcome of surgical management of oral potentially malignant disorders of the oral cavity and observe the prevalence of recurrence at the primary site and occurrence of another potentially malignant lesion in these patients. Methods The study participants included patients who had undergone clinical oral examination, surgical excision of biopsy-proven cases of dysplastic oral potentially malignant disorders (leukoplakia, erythroplakia, non-healing ulcerative and erosive areas, etc.) who were on routine follow-up as per the standard guidelines. These patients were followed up closely during each monthly follow-up visit for the first year. The patients were then prospectively analysed for any recurrence of lesion. On follow-up visits, detailed clinical oral examination was done to note the prevalence of a new lesion in any oral cavity sub site other than the previous site. If a new lesion was detected, then biopsy followed by surgical excision was followed as per standard guidelines. The follow-up period after the second surgical intervention was 12 months. Results Fifty patients with potentially malignant oral disorders underwent surgical excision. The majority of the study subjects were males (39/50) and 41 of them were below 65 years of age. Of 50 patients, 13 (26%) had second oral potentially malignant lesion other than the primary site. The rate of recurrence of the lesions at the primary site was 4% (2/50). Of these patients with recurrence, all had malignant transformation (2/2). Also, patients who were initially diagnosed with moderate dysplasia had a higher chance of recurrence. A second lesion at a site different from the primary lesion was seen in 26% of the cases. Conclusion Surgical management of such lesions with one-centimetre oncological margins in all dimensions contrary to the routine five millimetre surgical margins reduces the chance of recurrence.
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Affiliation(s)
- Adarsh Kudva
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India
| | - Mathangi Kumar
- Department of Oral Medicine & Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India
| | - Evit Rajan John
- School of Public Health, UT Health Science Center Houston, 7000 Fannin St #1200, Houston, TX 77030 USA
| | - Vasantha Dhara
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India
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Chrysophanol-Induced Autophagy Disrupts Apoptosis via the PI3K/Akt/mTOR Pathway in Oral Squamous Cell Carcinoma Cells. Medicina (B Aires) 2022; 59:medicina59010042. [PMID: 36676666 PMCID: PMC9864245 DOI: 10.3390/medicina59010042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/08/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
Background and Objectives: Natural products are necessary sources for drug discovery and have contributed to cancer chemotherapy over the past few decades. Furthermore, substances derived from plants have fewer side effects. Chrysophanol is an anthraquinone derivative that is isolated from rhubarb. Although the anticancer effect of chrysophanol on several cancer cells has been reported, studies on the antitumor effect of chrysophanol on oral squamous-cell carcinoma (OSCC) cells have yet to be elucidated. Therefore, in this study, we investigated the anticancer effect of chrysophanol on OSCC cells (CAL-27 and Ca9-22) via apoptosis and autophagy, among the cell death pathways. Results: It was found that chrysophanol inhibited the growth and viability of CAL-27 and Ca9-22 and induced apoptosis through the intrinsic pathway. It was also found that chrysophanol activates autophagy-related factors (ATG5, beclin-1, and P62/SQSTM1) and LC3B conversion. That is, chrysophanol activated both apoptosis and autophagy. Here, we focused on the roles of chrysophanol-induced apoptosis and the autophagy pathway. When the autophagy inhibitor 3-MA and PI3K/Akt inhibitor were used to inhibit the autophagy induced by chrysophanol, it was confirmed that the rate of apoptosis significantly increased. Therefore, we confirmed that chrysophanol induces apoptosis and autophagy at the same time, and the induced autophagy plays a role in interfering with apoptosis processes. Conclusions: Therefore, the potential of chrysophanol as an excellent anticancer agent in OSCC was confirmed via this study. Furthermore, the combined treatment of drugs that can inhibit chrysophanol-induced autophagy is expected to have a tremendous synergistic effect in overcoming oral cancer.
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Truchard E, Bertolus C, Martinez P, Thomas E, Saintigny P, Foy JP. Identification of a Gene-Expression-Based Surrogate of Genomic Instability during Oral Carcinogenesis. Cancers (Basel) 2022; 14:cancers14030834. [PMID: 35159101 PMCID: PMC8834046 DOI: 10.3390/cancers14030834] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary New personalized cancer prevention strategies may decrease the mortality of oral cancer that can arise from oral potentially malignant disorders (OPMD). A major cancer hallmark is the acquisition of multiple deletions or amplifications of genomic material fragments leading to genomic instability (GI). Our goal was to identify a set of genes whose expression was associated with GI. A total of 20 genes correlated with GI were identified in two independent datasets of head and neck cancer (including oral cancer). We computed a score of those genes, referred to as the GIN score, in with each sample from multiple validation datasets. We show that the GIN score: (i) was correlated with GI, (ii) increased at different stages of oral carcinogenesis from normal mucosa to oral cancer, and (iii) was associated with malignant transformation of OPMD. The GIN score is a promising biomarker for identifying patients suffering from OPMD with high risk of oral cancer. Abstract Background: Our goal was to identify a gene-expression-based surrogate of genomic instability (GI) associated with the transformation of oral potentially malignant disorder (OPMD) into oral squamous cell carcinoma (OSCC). Methods: GI was defined as the fraction of genome altered (FGA). Training sets included the CCLE and TCGA databases. The relevance of the enrichment score of the top correlated genes, referred to as the GIN score, was evaluated in eight independent public datasets from the GEO repository, including a cohort of patients with OPMD with available outcome. Results: A set of 20 genes correlated with FGA in head and neck SCC were identified. A significant correlation was found between the 20-gene based GIN score and FGA in 95 esophagus SCC (r = 0.59) and 501 lung SCC (r = 0.63), and in 33 OPMD/OSCC (r = 0.38). A significantly increased GIN score was observed at different stages of oral carcinogenesis (normal–dysplasia –OSCC) in five independent datasets. The GIN score was higher in 10 OPMD that transformed into oral cancer compared to 10 nontransforming OPMD (p = 0.0288), and was associated with oral-cancer-free survival in 86 patients with OPMD (p = 0.0081). Conclusions: The GIN score is a gene-expression surrogate of GI, and is associated with oral carcinogenesis and OPMD malignant transformation.
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Affiliation(s)
- Eléonore Truchard
- Sorbonne Université, Department of Maxillo-Facial Surgery, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France; (E.T.); (C.B.)
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, 69008 Lyon, France; (P.M.); (P.S.)
- Department of Translational Medicine, Centre Léon Bérard, 69008 Lyon, France
| | - Chloé Bertolus
- Sorbonne Université, Department of Maxillo-Facial Surgery, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France; (E.T.); (C.B.)
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, 69008 Lyon, France; (P.M.); (P.S.)
- Department of Translational Medicine, Centre Léon Bérard, 69008 Lyon, France
| | - Pierre Martinez
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, 69008 Lyon, France; (P.M.); (P.S.)
| | - Emilie Thomas
- Synergie Lyon Cancer-Platform of Bioinformatics Gilles Thomas, 69008 Lyon, France;
| | - Pierre Saintigny
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, 69008 Lyon, France; (P.M.); (P.S.)
- Department of Translational Medicine, Centre Léon Bérard, 69008 Lyon, France
- Department of Medical Oncology, Centre Léon Bérard, 69008 Lyon, France
| | - Jean-Philippe Foy
- Sorbonne Université, Department of Maxillo-Facial Surgery, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France; (E.T.); (C.B.)
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, 69008 Lyon, France; (P.M.); (P.S.)
- Department of Translational Medicine, Centre Léon Bérard, 69008 Lyon, France
- Correspondence: ; Tel.: +33-(0)1421-61448; Fax: +33-(0)1421-61449
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Pandita V, Ajila V, Babu S, Hegde S. Oral leukoplakia: A review of clinical features and trends in management. ACTA STOMATOLOGICA NAISSI 2022. [DOI: 10.5937/asn2285417p] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Introduction: Oral potentially malignant disorders (OPMD) conisit of the group of diseases of great importance for dentists. Oral leukoplakia (OL) has long been the subject of debate by numerous researchers. A common etiologic factor is tobacco, which is associated with oral cancer. The aim of the study is to indicate the severity of the lesion, the most common clinical characreistics and localization. The prevalence of leukoplakia in the world is 2.6% with a rate of malignant conversion ranging from 0.1% to 17.5%. Literature data about the prevalence and annual rate of malignant transformation, approximately 2%, indicate that these changes should be taken seriously and regularymonitored Conclusion: Occurate diagnosis provides the key to preventing to malignant transformation. Various medical and surgical treatment modalities for this lesion have been described. This article highlights various trends in the diagnosis and treatment of oral leukoplakia.
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Overview of Oral Potentially Malignant Disorders: From Risk Factors to Specific Therapies. Cancers (Basel) 2021; 13:cancers13153696. [PMID: 34359597 PMCID: PMC8345150 DOI: 10.3390/cancers13153696] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/09/2021] [Accepted: 07/16/2021] [Indexed: 12/12/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) is a very aggressive cancer, representing one of the most common malignancies worldwide. Oral potentially malignant disorders (OPMDs) regroup a variegate set of different histological lesions, characterized by the potential capacity to transform in OSCC. Most of the risk factors associated with OSCC are present also in OPMDs' development; however, the molecular mechanisms and steps of malignant transformation are still unknown. Treatment of OSCC, including surgery, systemic therapy and radiotherapy (alone or in combination), has suffered a dramatic change in last years, especially with the introduction of immunotherapy. However, most cases are diagnosed during the advanced stage of the disease, decreasing drastically the survival rate of the patients. Hence, early diagnosis of premalignant conditions (OPMDs) is a priority in oral cancer, as well as a massive education about risk factors, the understanding of mechanisms involved in malignant progression and the development of specific and more efficient therapies. The aim of this article is to review epidemiological, clinical, morphological and molecular features of OPMDs, with the purpose to lay the foundation for an exhaustive comprehension of these lesions and their ability of malignant transformation and for the development of more effective and personalized treatments.
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Centuori SM, Caulin C, Bauman JE. Precision and Immunoprevention Strategies for Tobacco-Related Head and Neck Cancer Chemoprevention. Curr Treat Options Oncol 2021; 22:52. [PMID: 33991232 PMCID: PMC8122210 DOI: 10.1007/s11864-021-00848-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 12/02/2022]
Abstract
OPINION STATEMENT To date, there is no FDA-approved chemoprevention approach for tobacco-related HNSCC. Effective chemoprevention approaches validated in sufficiently powered randomized trials are needed to reduce the incidence and improve survival. In this review, we recap the challenges encountered in past chemoprevention trials and discuss emerging approaches, with major focus on green chemoprevention, precision prevention, and immunoprevention. As our current depth of knowledge expands in the arena of cancer immunotherapy, the field of immunoprevention is primed for new discoveries and successes in cancer prevention.
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Affiliation(s)
- Sara M. Centuori
- Department of Medicine, University of Arizona, 1515 N. Campbell Ave, PO Box 245024, Tucson, AZ 85724-5024 USA
- University of Arizona Cancer Center, 1515 N. Campbell Ave, Tucson, AZ 85724 USA
| | - Carlos Caulin
- University of Arizona Cancer Center, 1515 N. Campbell Ave, Tucson, AZ 85724 USA
- Department of Otolaryngology-Head and Neck Surgery, University of Arizona, 1515 N. Campbell Ave, Tucson, AZ 85724 USA
| | - Julie E. Bauman
- Department of Medicine, University of Arizona, 1515 N. Campbell Ave, PO Box 245024, Tucson, AZ 85724-5024 USA
- University of Arizona Cancer Center, 1515 N. Campbell Ave, Tucson, AZ 85724 USA
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Oral potentially malignant disorders: new insights for future treatment. Curr Opin Otolaryngol Head Neck Surg 2020; 29:138-142. [PMID: 33394736 DOI: 10.1097/moo.0000000000000695] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to define the issues regarding oral potentially malignant disorders (OPMDs) and provide an overview of currently available treatments and ongoing clinical trials for future opportunities. RECENT FINDINGS Nowadays, the treatment of choice of OPMD is surgery, whose role in preventing malignant transformation is however limited because of the high rate of recurrence and field cancerization. There have been several attempts of combining systemic therapies with surgery to reduce risk of malignant transformation. The identification of biomarkers that could predict malignant transformation is crucial in better tailoring the risk profile and possible therapeutic approaches. SUMMARY Loss of heterozygosity remains the most predictive marker of malignant transformation; however, role of specific microRNA and OPMD immune infiltration are emerging as potential biomarkers. Given the failure of previous trials with various chemopreventive strategies, new strategies should be defined to address the issue of systemic prevention of malignant transformation. Recent updates about immune infiltration and the immune-equilibrium concept for OPMD could shed light into new preventive approaches.
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The 4-NQO mouse model: An update on a well-established in vivo model of oral carcinogenesis. Methods Cell Biol 2020; 163:197-229. [PMID: 33785166 DOI: 10.1016/bs.mcb.2020.09.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The early detection and management of oral premalignant lesions (OPMDs) improve their outcomes. Animal models that mimic histological and biological processes of human oral carcinogenesis may help to improve the identification of OPMD at-risk of progression into oral squamous cell carcinoma and to develop preventive strategies for the entire field of cancerization. No animal model is perfectly applicable for investigating human oral carcinogenesis. However, the 4-nitroquinoline 1-oxide (4-NQO) mouse model is well established and mimics several morphological, histological, genomic and molecular features of human oral carcinogenesis. Some of the reasons for the success of this model include its reproducible experimental conditions with limited variation, the possibility of realizing longitudinal studies with invasive intervention or gene manipulation, and sample availability for all stages of oral carcinogenesis, especially premalignant lesions. Moreover, the role of histological and molecular alterations in the field of cancerization (i.e., macroscopically healthy mucosa exposed to a carcinogen) during oral carcinogenesis can be easily explored using this model. In this review, we discuss the advantages and drawbacks of this model for studying human oral carcinogenesis. In summary, the 4-NQO-induced murine oral cancer model is relevant for investigating human oral carcinogenesis, including the immune microenvironment, and for evaluating therapeutic and chemoprevention agents.
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Sircan-Kucuksayan A, Yaprak N, Derin AT, Ozbudak İH, Turhan M, Canpolat M. Noninvasive assessment of oral lesions using elastic light single-scattering spectroscopy: a pilot study. Eur Arch Otorhinolaryngol 2020; 277:1467-1472. [PMID: 32016524 DOI: 10.1007/s00405-020-05824-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 01/22/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE In the present study, we investigated the potential application of elastic light single-scattering spectroscopy (ELSSS) as a noninvasive, adjunctive tool to differentiate between malignant and benign oral lesions in vivo. METHODS ELSSS spectra were acquired from 52 oral lesions of 47 patients prior to surgical biopsy using a single optical fiber probe. The sign of the spectral slope was used as a diagnostic parameter and was compared to the histopathology findings to obtain sensitivity and specificity of the ELSSS system in differentiating between benign and malignant tissues. RESULTS The sign of the spectral slope was positive for the benign tissues and negative for the malignant tissues. Nine malignant lesions and one high-grade dysplasia were correctly classified as cancerous. Six out of the ten low-grade dysplasia were correctly classified as cancerous, and four of them were misclassified as benign. Thirty benign lesions were correctly classified as benign, and two were misclassified as malignant. Our results indicate that the sign of the spectral slope enables the differentiation between malignant and benign oral lesions with a sensitivity of 80% and specificity of 94%. CONCLUSIONS ELSSS has the potential to be developed as an adjunctive screening tool in the noninvasive evaluation of oral lesions in vivo. This new diagnostic system may reduce the number of unnecessary biopsies.
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Affiliation(s)
| | - Neslihan Yaprak
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Akdeniz University, Dumlupınar Boulevard 07058 Campus, Antalya, Turkey.
| | - Alper Tunga Derin
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Akdeniz University, Dumlupınar Boulevard 07058 Campus, Antalya, Turkey
| | - İrem Hicran Ozbudak
- Department of Pathology, School of Medicine, Akdeniz University, Antalya, Turkey
| | - Murat Turhan
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Akdeniz University, Dumlupınar Boulevard 07058 Campus, Antalya, Turkey
| | - Murat Canpolat
- Department of Biophysics, School of Medicine, Akdeniz University, Antalya, Turkey
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Maulina T, Widayanti R, Hardianto A, Sjamsudin E, Pontjo B, Yusuf HY. The Usage of Curcumin as Chemopreventive Agent for Oral Squamous Cell Carcinoma: An Experimental Study on Sprague-Dawley Rat. Integr Cancer Ther 2019; 18:1534735418822094. [PMID: 30616418 PMCID: PMC6432668 DOI: 10.1177/1534735418822094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background: Curcumin, a natural herb that can be isolated from turmeric has been known for its therapeutic potential, including its chemopreventive potential, while heme oxygenase-1 (HO-1) is an antioxidant enzyme that can act as the biomarker for the progression of oral squamous cell carcinoma (OSCC). The current study investigated the efficacy of curcumin as a chemopreventive agent for OSCC by evaluating the immunoexpression of HO-1 at epithelial dysplasia stage. Methods: The current experimental study was conducted at the Veterinary Medicine Faculty, Bogor Agricultural Institute, Indonesia, using 40 Sprague-Dawley rats. All rats were randomly divided into 1 of 2 groups: the experimental group that was fed with standard rat food and curcumin and the control group that was fed with standard rat food without curcumin. At the beginning of the fifth week, every animal was wounded on the right buccal mucosa and was exposed to 0.5% 7,12-dymethylbenz(a)anthracene 3 times a week for 4 weeks in order to induce epithelial dysplasia of OSCC. On the ninth week, the right buccal mucosa was biopsied and the immunoexpression of HO-1 in both groups was compared and analyzed. Results: Sample examination revealed that all rats showed moderate to severe dysplastic epithelial dysplasia stage of OSCC, while a Mann-Whitney test showed that there was no significant (P = .09) difference found between the 2 groups for the immunoexpression of HO-1. Conclusion: With regard to its chemopreventive potential, the curcumin dose used in the study was not proven to be effective. Further study is of importance.
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Foy JP, Bertolus C, Saintigny P. Oral cancer prevention worldwide: Challenges and perspectives. Oral Oncol 2018; 88:91-94. [PMID: 30616804 DOI: 10.1016/j.oraloncology.2018.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 11/06/2018] [Indexed: 11/24/2022]
Affiliation(s)
- Jean-Philippe Foy
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, Lyon 69008, France; Department of Oral and Maxillo-Facial Surgery, Sorbonne University, Pitié-Salpêtrière Hospital, Paris, France
| | - Chloé Bertolus
- Department of Oral and Maxillo-Facial Surgery, Sorbonne University, Pitié-Salpêtrière Hospital, Paris, France
| | - Pierre Saintigny
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, Lyon 69008, France; Department of Medicine, Centre Léon Bérard, Lyon, France.
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Awadallah M, Idle M, Patel K, Kademani D. Management update of potentially premalignant oral epithelial lesions. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:628-636. [PMID: 29656948 DOI: 10.1016/j.oooo.2018.03.010] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 03/13/2018] [Accepted: 03/16/2018] [Indexed: 11/26/2022]
Abstract
The term oral potentially malignant disorders, proposed at the World Health Organization workshop in 2005, has now been renamed potentially premalignant oral epithelial lesions (PPOELs). It is important to differentiate among PPOELs, which is a broad term to define a wide variety of clinical lesions, and oral epithelial dysplasia, which should be reserved specifically for lesions with biopsy-proven foci of dysplasia. PPOELs encompass lesions that include leukoplakia, erythroplakia, erythroleukoplakia, lichen planus, and oral submucous fibrosis. The primary goal of management of dysplasia includes prevention, early detection, and treatment before malignant transformation. The aim of this article is to inform the clinician about management of PPOELs.
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Affiliation(s)
- Michael Awadallah
- Department of Oral and Maxillofacial Surgery, North Memorial Medical Center, Minneapolis, MN, USA
| | - Matthew Idle
- Department of Oral and Maxillofacial Surgery, North Memorial Medical Center, Minneapolis, MN, USA
| | - Ketan Patel
- Department of Oral and Maxillofacial Surgery, North Memorial Medical Center, Minneapolis, MN, USA
| | - Deepak Kademani
- Department of Oral and Maxillofacial Surgery, North Memorial Medical Center, Minneapolis, MN, USA.
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15
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Saintigny P, William WN, Foy JP, Papadimitrakopoulou V, Lang W, Zhang L, Fan YH, Feng L, Kim ES, El-Naggar AK, Lee JJ, Mao L, Hong WK, Lingen MW, Lippman SM. Met Receptor Tyrosine Kinase and Chemoprevention of Oral Cancer. J Natl Cancer Inst 2018; 110:4243526. [PMID: 29617836 PMCID: PMC5946820 DOI: 10.1093/jnci/djx186] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 06/20/2017] [Accepted: 08/08/2017] [Indexed: 12/11/2022] Open
Abstract
Background We have previously shown that gene expression profiles of oral leukoplakia (OL) may improve the prediction of oral cancer (OC) risk. To identify new targets for prevention, we performed a systematic survey of transcripts associated with an increased risk of oral cancer and overexpressed in OC vs normal mucosa (NM). Methods We used gene expression profiles of 86 patients with OL and available outcomes from a chemoprevention trial of OC and NM. MET expression was evaluated using immunohistochemistry in 120 OL patients, and its association with OC development was tested in multivariable analysis. Sensitivity to pharmacological Met inhibition was tested invitro in premalignant and OC cell lines (n = 33) and invivo using the 4-NQO model of oral chemoprevention (n = 20 mice per group). All statistical tests were two-sided. Results The overlap of 693 transcripts associated with an increased risk of OC with 163 transcripts overexpressed in OC compared with NM led to the identification of 23 overlapping transcripts, including MET. MET overexpression in OL was associated with a hazard ratio of 3.84 (95% confidence interval = 1.59 to 9.27, P = .003) of developing OC. Met activation was found in OC and preneoplastic cell lines. Crizotinib activity in preneoplastic and OC cell lines was comparable. ARQ 197 was more active in preneoplastic compared with OC cell lines. In the 4-NQO model, squamous cell carcinoma, dysplasia, and hyperkeratosis were observed in 75.0%, 15.0%, and 10.0% in the control group, and in 25.0%, 70.0%, and 5.0% in the crizotinib group (P < .001). Conclusion Together, these data suggest that MET activation may represent an early driver in oral premalignancy and a target for chemoprevention of OC.
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MESH Headings
- 4-Nitroquinoline-1-oxide/toxicity
- Animals
- Antineoplastic Agents/pharmacology
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Carcinoma, Squamous Cell/metabolism
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/prevention & control
- Case-Control Studies
- Cell Proliferation
- Crizotinib/pharmacology
- Female
- Follow-Up Studies
- Gene Expression Regulation, Neoplastic
- Genomics
- Head and Neck Neoplasms/metabolism
- Head and Neck Neoplasms/pathology
- Head and Neck Neoplasms/prevention & control
- Humans
- Leukoplakia, Oral/metabolism
- Leukoplakia, Oral/pathology
- Leukoplakia, Oral/prevention & control
- Male
- Mice, Inbred CBA
- Middle Aged
- Mouth Mucosa/drug effects
- Mouth Mucosa/metabolism
- Mouth Mucosa/pathology
- Mouth Neoplasms/metabolism
- Mouth Neoplasms/pathology
- Mouth Neoplasms/prevention & control
- Neoplasm Invasiveness
- Precancerous Conditions/metabolism
- Precancerous Conditions/pathology
- Precancerous Conditions/prevention & control
- Prognosis
- Prospective Studies
- Proto-Oncogene Proteins c-met/antagonists & inhibitors
- Proto-Oncogene Proteins c-met/genetics
- Proto-Oncogene Proteins c-met/metabolism
- Pyrrolidinones/pharmacology
- Quinolines/pharmacology
- Quinolones/toxicity
- Survival Rate
- Tumor Cells, Cultured
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Affiliation(s)
- Pierre Saintigny
- Cancer Research Center of Lyon, UMR INSERM 1052-CNRS 5286, Centre Léon Bérard, Lyon, France
- Department of Medicine, Centre Léon Bérard, Lyon, France, Université Lyon 1, Lyon, France
| | - William N William
- Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - Jean-Philippe Foy
- Cancer Research Center of Lyon, UMR INSERM 1052-CNRS 5286, Centre Léon Bérard, Lyon, France
- Department of Medicine, Centre Léon Bérard, Lyon, France, Université Lyon 1, Lyon, France
| | | | - Wenhua Lang
- Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - Li Zhang
- Bioinformatics and Computational Biology, The University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - You Hong Fan
- Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - Lei Feng
- Biostatistics, Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - Edward S Kim
- Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC
| | - Adel K El-Naggar
- Biostatistics, Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - J Jack Lee
- Biostatistics, Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - Li Mao
- Oncology and Diagnostic Science, University of Maryland Dental School, Baltimore, MD
| | - Waun Ki Hong
- Division of Cancer Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - Mark W Lingen
- Department of Pathology, The University of Chicago, Chicago, IL
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16
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Foy JP, Bertolus C, Goudot P, Deneuve S, Blanc E, Lasset C, Pérol D, Saintigny P. Bibliometric analysis of a century of research on oral erythroplakia and leukoplakia. J Oral Pathol Med 2018; 47:388-395. [DOI: 10.1111/jop.12683] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2018] [Indexed: 12/26/2022]
Affiliation(s)
- Jean-Philippe Foy
- INSERM 1052; CNRS 5286; Centre de Recherche en Cancérologie de Lyon; Centre Léon Bérard, Univ Lyon, Université Claude Bernard Lyon 1; Lyon France
- Department of Translational Research and Innovation; Centre Léon Bérard; Lyon France
- Department of Oral and Maxillo-Facial Surgery; Pitié-Salpêtrière Hospital; University of Paris 6; Paris France
| | - Chloé Bertolus
- Department of Oral and Maxillo-Facial Surgery; Pitié-Salpêtrière Hospital; University of Paris 6; Paris France
| | - Patrick Goudot
- Department of Oral and Maxillo-Facial Surgery; Pitié-Salpêtrière Hospital; University of Paris 6; Paris France
| | | | - Ellen Blanc
- Department of Clinical Research; Centre Léon Bérard; Lyon France
| | - Christine Lasset
- Department of Clinical Research; Centre Léon Bérard; Lyon France
| | - David Pérol
- Department of Clinical Research; Centre Léon Bérard; Lyon France
| | - Pierre Saintigny
- INSERM 1052; CNRS 5286; Centre de Recherche en Cancérologie de Lyon; Centre Léon Bérard, Univ Lyon, Université Claude Bernard Lyon 1; Lyon France
- Department of Translational Research and Innovation; Centre Léon Bérard; Lyon France
- Department of Medicine; Centre Léon Bérard; Lyon France
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17
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Foy JP, Tortereau A, Caulin C, Le Texier V, Lavergne E, Thomas E, Chabaud S, Perol D, Lachuer J, Lang W, Hong WK, Goudot P, Lippman SM, Bertolus C, Saintigny P. The dynamics of gene expression changes in a mouse model of oral tumorigenesis may help refine prevention and treatment strategies in patients with oral cancer. Oncotarget 2017; 7:35932-35945. [PMID: 27027432 PMCID: PMC5094973 DOI: 10.18632/oncotarget.8321] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 03/06/2016] [Indexed: 12/24/2022] Open
Abstract
A better understanding of the dynamics of molecular changes occurring during the early stages of oral tumorigenesis may help refine prevention and treatment strategies. We generated genome-wide expression profiles of microdissected normal mucosa, hyperplasia, dysplasia and tumors derived from the 4-NQO mouse model of oral tumorigenesis. Genes differentially expressed between tumor and normal mucosa defined the “tumor gene set” (TGS), including 4 non-overlapping gene subsets that characterize the dynamics of gene expression changes through different stages of disease progression. The majority of gene expression changes occurred early or progressively. The relevance of these mouse gene sets to human disease was tested in multiple datasets including the TCGA and the Genomics of Drug Sensitivity in Cancer project. The TGS was able to discriminate oral squamous cell carcinoma (OSCC) from normal oral mucosa in 3 independent datasets. The OSCC samples enriched in the mouse TGS displayed high frequency of CASP8 mutations, 11q13.3 amplifications and low frequency of PIK3CA mutations. Early changes observed in the 4-NQO model were associated with a trend toward a shorter oral cancer-free survival in patients with oral preneoplasia that was not seen in multivariate analysis. Progressive changes observed in the 4-NQO model were associated with an increased sensitivity to 4 different MEK inhibitors in a panel of 51 squamous cell carcinoma cell lines of the aerodigestive tract. In conclusion, the dynamics of molecular changes in the 4-NQO model reveal that MEK inhibition may be relevant to prevention and treatment of a specific molecularly-defined subgroup of OSCC.
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Affiliation(s)
- Jean-Philippe Foy
- INSERM U1052, Cancer Research Center of Lyon, Lyon, France.,CNRS UMR 5286, Cancer Research Center of Lyon, Lyon, France.,Department of Oral and Maxillofacial Surgery, University of Pierre Marie Curie-Paris 6, Pitié-Salpêtrière Hospital, Paris, France
| | - Antonin Tortereau
- Université de Lyon, VetAgro Sup, UPSP 2011-03-101, ICE, Marcy-l'Étoile, France
| | - Carlos Caulin
- Head and Neck Surgery at The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Emilie Lavergne
- Department of Biostatistics, Centre Léon Bérard, Lyon, France
| | - Emilie Thomas
- Department of Bioinformatics, Centre Léon Bérard, Lyon, France
| | - Sylvie Chabaud
- Department of Biostatistics, Centre Léon Bérard, Lyon, France
| | - David Perol
- Department of Biostatistics, Centre Léon Bérard, Lyon, France
| | - Joël Lachuer
- INSERM U1052, Cancer Research Center of Lyon, Lyon, France.,CNRS UMR 5286, Cancer Research Center of Lyon, Lyon, France.,Université Lyon 1, Université de Lyon, Lyon, France.,ProfileXpert, SFR-Est, CNRS UMR-S3453, INSERM US7, Lyon, France
| | - Wenhua Lang
- Thoracic/Head and Neck Medical Oncology at The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Waun Ki Hong
- Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Patrick Goudot
- Department of Oral and Maxillofacial Surgery, University of Pierre Marie Curie-Paris 6, Pitié-Salpêtrière Hospital, Paris, France
| | | | - Chloé Bertolus
- Department of Oral and Maxillofacial Surgery, University of Pierre Marie Curie-Paris 6, Pitié-Salpêtrière Hospital, Paris, France
| | - Pierre Saintigny
- INSERM U1052, Cancer Research Center of Lyon, Lyon, France.,CNRS UMR 5286, Cancer Research Center of Lyon, Lyon, France.,Departments of Medicine and Translational Research and Innovation, Centre Leon Berard, Lyon, France.,Centre Léon Bérard, Lyon, France
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18
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Özçaka Ö, Epstein JB, Güneri P. Inflammation in the assessment of salivary cytokines in oral squamous cell carcinoma diagnosis. Oral Oncol 2017; 71:96-98. [PMID: 28688699 DOI: 10.1016/j.oraloncology.2017.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 05/25/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Özgün Özçaka
- Department of Periodontology Ege University, School of Dentistry, Bornova 35100, İzmir, Turkey.
| | - Joel B Epstein
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Division of Otolaryngology and Head and Neck Surgery City of Hope National Medical Center, Duarte CA, 8500 Whilshire Blvd, Suite 800, Beverly Hills, CA 90211, USA
| | - Pelin Güneri
- Department of Oral and Maxillofacial Radiology, Ege University, School of Dentistry, Bornova 35100, İzmir, Turkey
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19
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The promising impact of molecular profiling on treatment strategies in oral cancers. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 118:242-247. [PMID: 28576460 DOI: 10.1016/j.jormas.2017.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 05/22/2017] [Indexed: 12/19/2022]
Abstract
Oral squamous cell carcinoma (OSCC) is a major cause of cancer-associated morbidity and mortality. Although OSCC may develop from easily accessible oral preneoplastic lesions (OPLs), no intervention has been reported so far that reduces the rate of malignant transformation. A comprehensive molecular characterization of oral carcinogenesis may help refining treatment strategies both in patients with OPLs and OSCC. Herein, we review main molecular alterations occurring at different steps during oral carcinogenesis and show how molecularly-based medicine and surgery may impact the outcome of OSCC in the future.
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20
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Güneri P, Epstein JB. Why are we still unable to accurately determine the malignant potential or the behavior of oral mucosal lesions? Oral Oncol 2017; 71:177-179. [PMID: 28456478 DOI: 10.1016/j.oraloncology.2017.04.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 04/12/2017] [Accepted: 04/19/2017] [Indexed: 11/15/2022]
Affiliation(s)
- Pelin Güneri
- Ege University School of Dentistry, Department of Oral and Maxillofacial Radiology, Bornova 35100, Izmir, Turkey.
| | - Joel B Epstein
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Division of Otolaryngology and Head and Neck Surgery City of Hope National Medical Center, Duarte CA, 8500 Whilshire Blvd, Suite 800, Beverly Hills, CA 90211, USA
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21
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Abstract
Cancer of the oral cavity is one of the most common malignancies worldwide. Although early diagnosis is relatively easy, presentation with advanced disease is not uncommon. The standard of care is primary surgical resection with or without postoperative adjuvant therapy. Improvements in surgical techniques combined with the routine use of postoperative radiation or chemoradiation therapy have resulted in improved survival. Successful treatment is predicated on multidisciplinary treatment strategies to maximize oncologic control and minimize impact of therapy on form and function. Prevention of oral cancer requires better education about lifestyle-related risk factors, and improved awareness and tools for early diagnosis.
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Affiliation(s)
- Pablo H Montero
- Head and Neck Surgery Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Snehal G Patel
- Head and Neck Surgery Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
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22
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Sheth SH, Johnson DE, Kensler TW, Bauman JE. Chemoprevention targets for tobacco-related head and neck cancer: past lessons and future directions. Oral Oncol 2015; 51:557-64. [PMID: 25868717 DOI: 10.1016/j.oraloncology.2015.02.101] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Revised: 01/21/2015] [Accepted: 02/25/2015] [Indexed: 11/26/2022]
Abstract
Progress toward identifying an effective chemopreventive agent to reduce the incidence of head and neck squamous cell carcinoma (HNSCC) has been limited by poor efficacy and intolerable toxicity profiles. In this review, we summarize the biological basis of HNSCC chemoprevention, and outline challenges associated with identifying appropriate high-risk HNSCC populations for chemoprevention studies. We discuss findings and lessons learned from clinical trials that have investigated micronutrient and molecular targeting interventions. Finally, we introduce the concept of green chemoprevention, interventions based upon whole plant foods or simple extracts that may represent a safe and cost-conscious option for the next generation of studies. As our scientific understanding of HNSCC reaches new levels, the field is poised to develop chemoprevention studies based on rigorous biological validation with accessibility to all affected individuals regardless of socioeconomic barriers.
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Affiliation(s)
| | - Daniel E Johnson
- Department of Medicine, University of Pittsburgh, United States; Departments of Pharmacology and Chemical Biology, University of Pittsburgh, United States
| | - Thomas W Kensler
- Departments of Pharmacology and Chemical Biology, University of Pittsburgh, United States
| | - Julie E Bauman
- Department of Medicine, University of Pittsburgh, United States.
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23
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Han YM, Park JM, Lee HJ, Kim EH, Hahm KB. Short-term Intervention to Revert Premalignant Lesions as Strategy to Prevent Gastrointestinal Cancers. J Cancer Prev 2014; 18:289-97. [PMID: 25337558 PMCID: PMC4189441 DOI: 10.15430/jcp.2013.18.4.289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 09/11/2013] [Accepted: 09/12/2013] [Indexed: 12/20/2022] Open
Abstract
"Prevention might be better than treatment in cancer treatment" is brief conclusion drawn from war on cancer through National Cancer Act of 1971 by U.S. President Richard Nixon. However, the clinical practice of chemoprevention is still in its infancy in spite of a wealth of data showing its effectiveness in experimental animals as well as in vitro mechanism research. Recent advances in either high throughput analysis including cancer genomes and tailored medicine or molecular targeted therapeutics, preventive strategies also should be changes as previous preventive strategies including phytoceuticals, life-style modification, and some empirical agents. Furthermore, molecular targeted therapeutics achieved high goal of effectiveness under the concept of therapeutic or preventive "synthetic lethality", of which extended application can be included within the scope of chemoprevention. Here, we will summarize several recent advances in chemopreventive strategy objected to justify optimism that chemoprevention will be an effective approach for the control of human cancer. siTRP (short-term intervention to revert premalignancy) strategy will be introduced for cancers in gastroenterology.
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Affiliation(s)
- Young-Min Han
- CHA Cancer Prevention Research Center, CHA Cancer Institute, CHA University, Seoul ; College of Pharmacy, CHA University, Pocheon
| | - Jong-Min Park
- CHA Cancer Prevention Research Center, CHA Cancer Institute, CHA University, Seoul
| | - Ho-Jae Lee
- Lee Gil Ya Cancer and Diabetes Research Institute, Gachon University, Incheon
| | - Eun-Hee Kim
- CHA Cancer Prevention Research Center, CHA Cancer Institute, CHA University, Seoul ; Lee Gil Ya Cancer and Diabetes Research Institute, Gachon University, Incheon
| | - Ki Baik Hahm
- CHA Cancer Prevention Research Center, CHA Cancer Institute, CHA University, Seoul ; Department of Gastroenterology, CHA Bundang Medical Center, Seongnam, Korea
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24
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Nagao T, Warnakulasuriya S, Nakamura T, Kato S, Yamamoto K, Fukano H, Suzuki K, Shimozato K, Hashimoto S. Treatment of oral leukoplakia with a low-dose of beta-carotene and vitamin C supplements: a randomized controlled trial. Int J Cancer 2014; 136:1708-17. [PMID: 25156040 DOI: 10.1002/ijc.29156] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 07/29/2014] [Accepted: 08/08/2014] [Indexed: 12/31/2022]
Abstract
Management of oral leukoplakia-a potentially malignant disorder-is currently not evidence-based. Of the few randomized trials that have been reported, most have negative data. Therefore, a multi-centre, randomized, double-blind controlled trial (RCT) was undertaken to evaluate the use of low-dose beta-carotene combined with vitamin C supplements for the treatment and to prevent malignant transformation of oral leukoplakia. 46 Japanese participants with oral leukoplakia were allocated randomly either to an experimental arm (10 mg day(-1) of beta-carotene and 500 mg day(-1) of vitamin C) or placebo arm (50 mg day(-1) of vitamin C). Current or ex-smokers within 3 months of cessation were excluded. The supplements were continued over a period of 1 year. The primary endpoint was clinical remission at 1-year and the likelihood of malignant transformation during a 5-year follow-up period as a secondary endpoint. The overall clinical response rate in the experimental arm was 17.4% (4/23) and 4.3% (1/23) in the placebo arm (p = 0.346). During the median 60-month follow-up period, two subjects in the experimental arm and three in the control arm developed oral cancer. Under the intention-to-treat principle, relative risk by supplementing with beta-carotene and vitamin C was 0.77 (95%CI: 0.28-1.89) (p = 0.580) by the Cox proportional hazards model. No unfavorable side-effects were noted. Beta-carotene (10 mg day(-1) ) and vitamin C were neither effective for clinical remission, nor for protection against the development of cancer. Data from this RCT does not support the hypothesis that chemoprevention with this treatment is effective for oral leukoplakia.
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Affiliation(s)
- Toru Nagao
- Department of Oral and Maxillofacial Surgery and Stomatology, Okazaki City Hospital, Okazaki, Japan; Department of Oral Medicine, WHO Collaborating Centre for Oral Cancer/Precancer, King's, College London Dental Institute at Guy's, King's & St. Thomas' Hospitals, London, United Kingdom; Department of Maxillofacial Surgery, Aichi-Gakuin University School of Dentistry, Nagoya, Japan; Department of Hygiene, Fujita Health University School of Medicine, Toyoake, Japan
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