Limited Data Available on Genetic Drivers of HNSCC in Low- Risk Patients

Comment: In recent years, there has been a rise in the incidence of HNSCC—particularly of the oral cavity—in low risk, nontraditional patients. To date, studies have implicated mutations in DNA repair mechanisms and apoptosis pathways among other genes. Further understanding of the genetic factors that predispose low-risk patients to develop HNSCC is essential to improve treatment and clinical outcomes. —Andres Bur, MD

What is the current landscape of genetic determinants of HNSCC in low-risk patients?

Bottom line
At present, there is a lack of robust, comprehensive data on genetic drivers of oncogenesis in low-risk patients and a clear need for further research on genetic alterations underlying the rising incidence of HNSCC in low-risk, nontraditional patients.

Background: The past two decades have seen an increased incidence of head and neck squamous cell carcinoma (HNSCC) in a nontraditional, low-risk patient population (i.e., younger than 45 years of age with no history of substance use), owing to a combination of human papillomavirus (HPV) infection and individual genetic variation. Recently, the International Head and Neck Cancer Epidemiology (INHANCE) consortium aimed to compare the role of family history of HNSCC, tobacco, and alcohol as oncologic risk factors among a large cohort of young (≤45 years) and older (≥45 years) patients.