Potential molecular prognostic markers in head and neck squamous cell carcinomas

Background. Current management strategies for squamous cell carcinoma of th e head and neck (HNSCC) rely on an understanding of the natural history of the disease, along with the use of prognostic factors to guide selection of appropriate treatment. However, it is recognized that tumor heterogeneity limits the reliable use of currently available prognostic markers. With the evolving understanding of the genetic and molecular basis of human maligna ncies, there has been much interest in determining whether specific molecul ar changes in HNSCC might guide treatment decisions. Methods. A literature review of potential molecular markers relevant to HNS CC was undertaken and evaluated. It is evident that the published informati on is promising but, oftentimes, limited by a scarcity of large, uniformly staged and treated patients, from which the value of novel molecular marker s can be assessed. Results. On the basis of the review of more than 100 articles, some of the emerging molecular markers that might provide independent prognostic inform ation include epidermal growth factor receptor (EGFR), transforming growth factor-alpha (TGF-alpha), cyclin D1, and p53. This review will discuss the current status of these molecular factors and consequent implications for n ovel therapeutic approaches for patients with HNSCC. Conclusion. With the evolving understanding that human malignancies have de veloped and progressed on the basis of accumulated molecular abnormalities, there is an existing body of work trying to determine whether such abnorma lities can predict clinical behavior of HNSCC. Such studies have to be cond ucted rigorously to derive useful information. Nevertheless, the role of su ch molecular markers, and the possibility to exploit them for therapeutic g ain, is already at the horizon. (C) 2001 John Wiley & Sons, Inc.