Genomic-based treatment of patients with head and neck cancer

ABSTRACT Introduction Head and neck squamous cell carcinomas (HNSCC) are a heterogeneous group of malignancies which make up approximately 5% of all cancers worldwide. Molecular profiling of HNSCC tumors has identified a large number of genetic and epigenetic alterations that contribute to carcinogenesis, though genomic testing currently has a limited role in the treatment of HNSCC. Areas covered Molecular testing and use of targeted therapies are generally limited to the treatment of those with recurrent or metastatic disease or within clinical trials. Given the significant morbidity associated with the treatment of HNSCC, there is growing interest in identifying molecular alterations that drive carcinogenesis and have potential as clinical biomarkers and therapeutic targets. This article aims to review the current literature regarding clinical implications for common molecular alterations in HNSCC tumors and the developing role for genomic analysis in the treatment of this disease. Expert opinion Improved understanding of how molecular alterations contribute to carcinogenesis is essential to guide further research and to develop improved treatment strategies. While there are many promising treatment strategies under investigation, ongoing research is needed before genomic testing and targeted therapy will routinely be incorporated into clinical care for most patients.