Genetic alterations and clinical dimensions of oral cancer: a review
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REVIEW
Genetic alterations and clinical dimensions of oral cancer: a review Keerthana Karunakaran1 · Rajiniraja Muniyan1 Received: 24 August 2020 / Accepted: 16 October 2020 © Springer Nature B.V. 2020
Abstract Oral cancer ranks sixth most prevalent type of cancer worldwide due to its alarming increase every year. Progression of oral cancer depends on various heterogeneity pathways, but their exact mechanism remains unclear. Genetic aberrations on oral cancer cells set back the effectiveness of existing therapies and make it more challenging by triggering drug resistance. To understand the intricate details of oral cancer pathogenesis and for advancing current therapies, genetic modifications are the most promising approach. In this review, we tabulated the information on genetic alterations, microbial associations, aberrant signalling pathways and their clinicopathological characters on the pathogenesis of oral cancer. We primarily discussed the pitfalls of the current treatment regimen and its associated drug resistance pattern, which will provide a clear insight into developing new drugs. We also highlighted the genetic-molecular targets with their current clinical status on drug development and its outcome. Keywords Oral squamous cell carcinoma · Microbes · Genes · Therapeutics · Drug resistance · Clinical phases
Introduction Head and neck cancer, the sixth prevalent cancer worldwide begins in the epithelial lining of the upper-digestive tracts such as the oral cavity and larynx [1]. Based on its position and cells that get affected, it is graded as oral and pharyngeal cancer, squamous cell carcinoma and adenocarcinoma. Cancer patterns vary across different regions of the world where oral squamous cell carcinoma (OSCC) or oral cancer ranks the first in infecting males, third among females especially in developing countries like India, Sri Lanka, and Bangladesh owing to their lack of knowledge about the consequences of tobacco and alcohol [1]. Recently, developed countries also reported increased OSCC cases due to changes in their lifestyle. The second most prevalent cancer in transplant patients is OSCC (e.g., Leukaemia, multiple myeloma, and lymphoma). It is a curable disease when noticed early, but inevitably mortal when diagnosed too late. Surgery in the initial stages and combination therapy (chemotherapy, * Rajiniraja Muniyan [email protected] Keerthana Karunakaran [email protected] 1
School of Bio‑Sciences and Technology, Vellore Institute of Technology, Vellore, Tamil Nadu 632014, India
radiotherapy) in later stages are the selected treatments for oral cancer [2]. Despite these available treatments, survival rate is not improved significantly as the accumulation of genetic mutations impaired the effectiveness of drugs through therapeutic resistance. Oral cancer is a heterogeneous disease common in males than females caused due to the mutation in tumour suppressor genes, oncogenes, DNA repair genes, immuneinflammatory genes and other genes, in association with the exposure of tobacco, be
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