Temporal and spatial patterns of recurrence in oral squamous cell carcinoma, a single-center retrospective cohort study in China

Targeting fibroblast growth factor receptor (FGFR) with inhibitors in head and neck cancers: Their roles, mechanisms and challenges

Head and neck squamous cell carcinoma (HNSCC) is a common and aggressive type of cancer with significant rates of morbidity and mortality. Traditional treatment options, including radiotherapy, chemotherapy, and surgery, are widely used, but their effectiveness can be uncertain. As research in cancer therapies evolves, molecular-targeted therapies are increasingly recognized as promising alternatives for managing malignant tumors. Fibroblast growth factor receptors (FGFRs) have been shown to be one of the essential components in the pathways in the progression of HNSCC. This review aims to summarize and discuss the structure, functions, signaling pathways, abnormal alterations of FGFRs, and their roles in tumorigenesis and development. We have accumulated information from in vitro, in vivo, and clinical studies regarding FGFR inhibitors in HNSCC. However, the efficacy of FGFR inhibitors as a cancer therapy is limited, which may be due to the resistance to FGFR inhibitors. In this review we also discuss the potential mechanisms of FGFR inhibitor resistance in HNSCC. By enriching our understanding of the treatment with and resistance of FGFR inhibitors in HNSCC, researchers may unveil new therapeutic targets or strategies to enhance the efficacy of FGFR inhibitors in this context.

Enhancing Cisplatin Delivery via Liposomal Nanoparticles for Oral Cancer Treatment

Investigating the impact of liposomal Cisplatin on oral cancer cell line seeks to optimize drug delivery efficiency, decrease systemic toxicity, and amplify cytotoxicity specifically against malignant cells. Cisplatin was encapsulated within liposomal nanoparticles through thin-film hydration and extrusion methodologies. The physical and chemical characteristics of the nanoparticles, including zeta potential, size, drug load, and polydispersity index (PDI), were examined to evaluate their properties. The release of the drug was studied in a simulated body fluid environment in vitro. The stability of the nanoparticles was evaluated over a period of 45 days under normal bodily conditions. Ultimately, the liposomal formulations' efficacy was assessed in comparison to free drugs through cell viability assays conducted on the human tongue squamous cell carcinoma cell line CAL 27. The liposomal nanoparticles developed exhibited a favorable size range of 170 nm, a zeta potential of - 30 mV, and a low PDI of under 0.19, demonstrating uniform particle sizes. The encapsulation efficiencies were about % 90, and the drug loading capacities were sufficient. The in vitro release profiles displayed a sustained release pattern over 72 h. The liposomal formulations showed improved stability, with no notable changes in physicochemical properties throughout the study period. Cytotoxicity evaluations revealed that the liposomal Cisplatin formulation exhibited a remarkably higher cytotoxic effect on an oral cancer cell line relative to the unencapsulated drug. This research showcases the promise of liposomal formulations in optimizing the clinical efficacy of oral cancer treatments under superior drug delivery, diminished toxicity, and augmented cytotoxicity.

Determinants of oral cavity cancer recurrence in Pakistan: findings from a cross-sectional study using an institutional cancer registry

INTRODUCTION

Pakistan has a high prevalence of oral cavity cancer (OCC) with a significant recurrence rate. This study aims to explore the factors associated with OCC recurrence in Karachi, Pakistan.

METHODS

This cross-sectional study was conducted at the Aga Khan University Hospital (AKUH) Karachi, Pakistan, using data from the AKUH Cancer Registry. A total of 1692 biopsy-confirmed cases of OCC including cancers of mucosal lip, tongue, gum, oral cavity floor, palate and other subsites like retromolar area, diagnosed between May 2011 and December 2020, were included in our study.

RESULTS

Of the 1692 patients, 611 (36.1%) experienced recurrence. Being male was associated with significantly increased odds of OCC recurrence compared to being female (Prevalence Odds Ratio (POR) = 1.70, 95% CI = 1.25-2.30). Moderately and poorly differentiated tumors had higher odds of recurrence (POR = 1.44, 95% CI = 1.02-2.02 and POR = 2.35, 95% CI = 1.49-3.71 respectively). Lymph node involvement was significantly associated with increased odds of recurrence. Patients with N1, N2 and N3 lymph node involvement had significantly higher odds of recurrence (POR = 1.45, 95% CI = 1.02-2.07 for N1, POR = 2.12, 95% CI = 1.57-2.87 for N2 and POR = 3.50, 95% CI = 1.72-7.11 for N3 respectively). Surgical treatment outside AKUH was associated with higher OCC recurrence (POR = 1.68, 95% CI = 1.12-2.50). Surgery alone (POR = 0.02, 95% CI = 0.00-0.16) and in combination with radiation (POR = 0.02, 95% CI = 0.00-0.16) or chemoradiation (POR = 0.04, 95% CI = 0.01-0.33) was protective against recurrence.

CONCLUSION

This study's findings identified factors increasing oral cavity cancer recurrence, highlighting the importance of considering these factors in the management and follow up of patients with OCC. Understanding these factors will not only help enhance patient care, but also improve patient education about their disease prognosis. Further research is needed to explore the underlying mechanisms and develop targeted interventions to improve outcomes for patients with OCC.

Comparison of Clinical Parameters, Histopathological Features and Status of Intraoperative Surgical Margins Between Recurrent and Non-Recurrent Oral Squamous Cell Carcinoma

AIM

To assess the role of various clinical and histological parameters in depicting recurrence in oral squamous cell carcinoma (OSCC).

METHODOLOGY

After seeking clearance from the institutional ethical clearance board, 171 excised cases of OSCC were included in the present study and divided into two groups (recurrent OSCC-rOSCC and non-recurrent OSCC- nOSCC). Data pertaining to the age, gender, site, laterality, histological grade, perineural invasion (PNI), lymphovascular emboli (LVE), bone invasion, depth of invasion, pathological tumor stage, nodal metastases, the status of surgical margins-intraoperatively, and recurrence were recorded and compared utilizing SPSS software.

RESULT

There was no statistically significant difference between the mean age of nOSCC (51.03±10.27 years) and rOSCC (51.87±10.39 years). Similary, no statistically significant differences were noted between the two study groups in the purview of the site (p-value: 0.505), laterality (p-value: 0.954), histological grade (p-value: 0.370), LVE (p value:0.109), bone involvement (p-value: 0.290), depth of invasion (p-value: 0.091) and pathological tumor stage (p-value: 0.174). However, there were significantly more instances of PNI (p-value: <0.001) and nodal metastasis in rOSCC (p-value: 0.019). Further, a statistically significant association was noted between the status of the margins at initial resection as compared to cases where clearance was achieved by subsequent revisions (p-value: <0.001).

CONCLUSION

Perineural invasion, positive margins at the initial cut and positive nodal metastasis are associated with higher recurrence in oral squamous cell carcinoma.

The Use of Immune Regulation in Treating Head and Neck Squamous Cell Carcinoma (HNSCC)

Immunotherapy has emerged as a promising new treatment modality for head and neck cancer, offering the potential for targeted and effective cancer management. Squamous cell carcinomas pose significant challenges due to their aggressive nature and limited treatment options. Conventional therapies such as surgery, radiation, and chemotherapy often have limited success rates and can have significant side effects. Immunotherapy harnesses the power of the immune system to recognize and eliminate cancer cells, and thus represents a novel approach with the potential to improve patient outcomes. In the management of head and neck squamous cell carcinoma (HNSCC), important contributions are made by immunotherapies, including adaptive cell therapy (ACT) and immune checkpoint inhibitor therapy. In this review, we are focusing on the latter. Immune checkpoint inhibitors target proteins such as programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) to enhance the immune response against cancer cells. The CTLA-4 inhibitors, such as ipilimumab and tremelimumab, have been approved for early-stage clinical trials and have shown promising outcomes in terms of tumor regression and durable responses in patients with advanced HNSCC. Thus, immune checkpoint inhibitor therapy holds promise in overcoming the limitations of conventional therapies. However, further research is needed to optimize treatment regimens, identify predictive biomarkers, and overcome potential resistance mechanisms. With ongoing advancements in immunotherapy, the future holds great potential for transforming the landscape of oral tumor treatment and providing new hope for patients.

Association of Site and Recurrence in Oral Squamous Cell Carcinoma Patients Visiting Private Hospital in Chennai: A Retrospective Study

BACKGROUND

Oral squamous cell carcinoma (OSCC) is the most common malignant neoplasms of the oral cavity. Tongue, buccal mucosa, and gingivobuccal sulcus are the most commonly involved sites for the local recurrence of OSCC. The site of the tumor can be a critical parameter in relation to the recurrence of OSCC because of the varied action of tumor cells in different tumor macro and microenvironments. Hence, the current study aims to evaluate the correlation between the site and recurrence of OSCC among patients visiting private oral cancer hospitals.

MATERIALS AND METHODS

Details of n=300 OSCC cases reported during 2019-2023, which included primary and recurrent OSCC, were collected. The sample population selected includes 261 primary and 39 recurrent oral squamous cell carcinoma cases. The demographic and clinicopathological data were retracted from the institution's common clinical database and transported to IBM-SPSS 23 software for statistical analysis. Chi-square was done to evaluate the association between site and recurrence status, and p<0.05 was considered statistically significant.

RESULTS

Males have a high predilection for OSCC, and the recurrent cases account for 13% of the sample population. The buccal mucosa was the most commonly affected site in primary and recurrent OSCC cases. However, the association between the site of the lesion and the status of recurrence was found to be statistically significant, with a p-value of 0.001.

CONCLUSION

Even though buccal mucosa was the most common site for recurrent OSCC(p value-0.001), the present study carries a small sample size and a location-specific sampling. Hence, further studies must be conducted with a large sample size to test the significant correlation between the site and recurrence rate among patients diagnosed with OSCC.