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Chemoprevention in Oral Cancer

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Textbook of Oral Cancer

Part of the book series: Textbooks in Contemporary Dentistry ((TECD))

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Abstract

Despite a new understanding of the molecular biology of oral cancer and the development of promising new approaches for the treatment of oral cancer, this disease remains a major source of morbidity and mortality worldwide. Prevention of oral cancer, using pharmacologic or immunologic approaches, is a promising strategy to combat the devastating effects associated with the diagnosis of invasive malignancy. An understanding of the early molecular events leading to the development of cancer is critical to the identification of appropriate targets for early intervention. Refinement of clinical trial methodologies to assess efficacy in early-phase cancer prevention clinical trials and appropriate identification of high-risk individuals who are most likely to benefit from interventions are key to making progress. This chapter summarizes the state of knowledge and ongoing efforts in oral cancer prevention.

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References

  1. Hong WK, Sporn MB. Recent advances in chemprevention of cancer. Science. 1997;278:1073–7.

    Article  PubMed  Google Scholar 

  2. Sporn MB. Approaches to prevention of epithelial cancer during the preneoplastic period. Cancer Res. 1976;36:2699–702.

    PubMed  Google Scholar 

  3. Hong WK, Lippman SM, Hittelman WN, Lotan R. Retinoid chemoprevention of aerodigestive cancer: from basic research to the clinic. Clin Cancer Res. 1995;1:677–86.

    Google Scholar 

  4. Maresso KC, Tsai KY, Brown PH, Szabo E, Lippman S, Hawk ET. Molecular cancer prevention: current status and future directions. CA Cancer J Clin. 2015;65(5):345–83.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Brahme NN, Szabo E. Cancer prevention in the era of precision oncology. Clin Pharmacol Ther. 2017;101(5):575–7.

    Article  PubMed  Google Scholar 

  6. Castle PE, Maza M. Prophylactic HPV vaccination: past, present, and future. Epidemiol Infect. 2016;144(3):449–68.

    Article  PubMed  Google Scholar 

  7. Vineis P, Schatzkin A, Potter JD. Models of carcinogenesis: an overview. Carcinogenesis. 2010;31(10):1703–9.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Lippman SM, Benner SE, Hong WK. Retinoids in chemoprevention of heck and neck carcinogenesis. Prev Med. 1993;22:693–700.

    Article  PubMed  Google Scholar 

  9. Lotan R. Retinoids and chemoprevention of aerodigestive tract cancers. Cancer Metastasis Rev. 1997;16:349–56.

    Article  PubMed  Google Scholar 

  10. Hong WK, Endicott J, Itri LM, Doos W, Batsakis JG, Bell R, Fofonoff S, Byers R, Atkinson EN, Vaughan C, et al. 13-cis-retinoic acid in the treatment of oral leukoplakia. NEJM. 1986;315(24):1501–5.

    Article  PubMed  Google Scholar 

  11. Hong WK, Lippman SM, Itri LM, Karp DD, Lee JS, Byers RM, Schantz SP, Kramer AM, Lotan R, Peters LJ, et al. Prevention of second primary tumors with isotretinoin in squamous-cell carcinoma of the head and neck. N Engl J Med. 1990;323(12):795–801.

    Article  PubMed  Google Scholar 

  12. Khuri FR, Lee JJ, Lippman SM, Kim ES, Cooper JS, Benner SE, Winn R, Pajak TF, Williams B, Shenouda G, et al. Randomized phase III trial of low-dose isotretinoin for prevention of second primary tumors in stage I and II head and neck cancer patients. J Natl Cancer Inst. 2006;98(7):441–50.

    Article  PubMed  Google Scholar 

  13. Suda D, Schwartz J, Shklar G. Inhibiton of experimental oral carcinogenesis by topical beta carotene. Carcinogenesis. 1986;7(5):711–5.

    Article  PubMed  Google Scholar 

  14. Alam BS, Alam SQ. The effect of different levels of dietary beta-carotene on DMBA-induced salivary gland tumors. Nutr Cancer. 1987;9(2–3):93–101.

    Article  PubMed  Google Scholar 

  15. Lippman S, Batsakis JG, Toth BB, Weber RS, Lee JJ, Martin JW, Hays GL, Goepfert H, Hong WK. Comparison of low-dose isotretinoin with beta carotene to prevent oral carcinogenesis. NEJM. 1993;328(1):15–20.

    Article  PubMed  Google Scholar 

  16. William WN Jr, Lee JJ, Lippman SM, Martin JW, Chakravarti N, Tran HT, Sabichi AL, Kim ES, Feng L, Lotan R, et al. High-dose fenretinide in oral leukoplakia. Cancer Prev Res (Phila). 2009;2(1):22–6.

    Article  Google Scholar 

  17. Phillips E, Wang TW, Husten CG, Corey CG, Apelberg BJ, Jamal A, Homa DM, King BA. Tobacco product use among adults – United States, 2015. Morb Mortal Wkly Rep. 2017;66(44):1209–15.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Room R. Smoking and drinking as complementary behaviours. Biomed Pharmacother. 2004;58(2):111–5.

    Article  PubMed  Google Scholar 

  19. Califano JA, van der Riet P, Westra W, Nawroz H, Clayman G, Piantadosi S, Corio R, Lee D, Greenberg B, Koch W, et al. Genetic progression model for head and neck cancer: implications for field cancerization. Cancer Res. 1996;56:2488–92.

    PubMed  Google Scholar 

  20. Network TCGA. Comprehensive genomic characterization of head and neck squamous cell carcinomas. Nature. 2015;517(7536):576–82.

    Article  Google Scholar 

  21. Szabo E. Phase II cancer prevention clinical trials. Semin Oncol. 2010;37(4):359–66.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ha PK, Chang SS, Glazer CA, Califano JA, Sidransky D. Molecular techniques and genetic alterations in head and neck cancer. Oral Oncol. 2009;45(4–5):335–9.

    Article  PubMed  Google Scholar 

  23. Ausoni S, Boscolo-Rizzo P, Singh B, Da Mosto MC, Spinato G, Tirelli G, Spinato R, Azzarello G. Targeting cellular and molecular drivers of head and neck squamous cell carcinoma: current options and emerging perspectives. Cancer Metastasis Rev. 2016;35(3):413–26.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Szabo E. Selecting targets for cancer prevention: where do we go from here? Nat Rev Cancer. 2006;6(11):867–74.

    Article  PubMed  Google Scholar 

  25. Alexandrov LB, Ju YS, Haase K, Van Loo P, Martincorena I, Nik-Zainal S, Totoki Y, Fujimoto A, Nakagawa H, Shibata T, et al. Mutational signatures associated with tobacco smoking in human cancer. Science. 2016;354(6312):618–25.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Alexandrov LB, Nik-Zainal S, Wedge DC, Aparicio SA, Behjati S, Biankin AV, Bignell GR, Bolli N, Borg A, Borresen-Dale AL, et al. Signatures of mutational processes in human cancer. Nature. 2013;500(7463):415–21.

    Article  PubMed  PubMed Central  Google Scholar 

  27. de Castro G Jr, Negrao MV. The cancer genome atlas findings in head and neck cancer: a renewed hope. Curr Opin Oncol. 2014;26(3):245–6.

    Article  PubMed  Google Scholar 

  28. Lee JJ, Hong WK, Hittelman WN, Mao L, Lotan R, Shin DM, Benner SE, Xu X-C, Lee JS, Papadimitrakopoulou VM, et al. Predicting cancer development in oral leukoplakia: ten years of translational research. Clin Cancer Res. 2000;6:1702–10.

    PubMed  Google Scholar 

  29. Rock LD, Rosin MP, Zhang L, Chan B, Shariati B, Laronde DM. Characterization of epithelial oral dysplasia in non-smokers: first steps towards precision medicine. Oral Oncol. 2018;78:119–25.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Zhang L, Poh CF, Williams M, Laronde DM, Berean K, Gardner PJ, Jiang H, Wu L, Lee JJ, Rosin MP. Loss of heterozygosity (LOH) profiles–validated risk predictors for progression to oral cancer. Cancer Prev Res (Phila). 2012;5(9):1081–9.

    Article  Google Scholar 

  31. Rosin MP, Cheng X, Poh C, Lam WL, Huang Y, Lovas J, Berean K, Epstein JB, Priddy R, Le ND, et al. Use of the allelic loss to predict malignant risk for low-grade oral epithelial dysplasia. Clin Cancer Res. 2000;6(2):357–62.

    PubMed  Google Scholar 

  32. Lingen MW, Szabo E. Validation of LOH profiles for assessing oral cancer risk. Cancer Prev Res (Phila). 2012;5(9):1075–7.

    Article  Google Scholar 

  33. William WN Jr, Papadimitrakopoulou V, Lee JJ, Mao L, Cohen EE, Lin HY, Gillenwater AM, Martin JW, Lingen MW, Boyle JO, et al. Erlotinib and the risk of oral cancer: the Erlotinib Prevention of Oral Cancer (EPOC) randomized clinical trial. JAMA Oncol. 2016;2(2):209–16.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Schatzkin A, Gail M. The promise and peril of surrogate end points in cancer research. Nat Rev Cancer. 2002;2(1):19–27.

    Article  PubMed  Google Scholar 

  35. Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011;144(5):646–74.

    Article  PubMed  Google Scholar 

  36. Spira A, Beane J, Shah V, Liu G, Schembri F, Yang X, Palma J, Brody JS. Effects of cigarette smoke on the human airway epithelial cell transcriptome. Proc Natl Acad Sci U S A. 2004;101(27):10143–8.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Sridhar S, Schembri F, Zeskind J, Shah V, Gustafson AM, Steiling K, Liu G, Dumas YM, Zhang X, Brody JS, et al. Smoking-induced gene expression changes in the bronchial airway are reflected in nasal and buccal epithelium. BMC Genomics. 2008;9:259.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Boyle JO, Gumus ZH, Kacker A, Choksi VL, Bocker JM, Zhou XK, Yantiss RK, Hughes DB, Du B, Judson BL, et al. Effects of cigarette smoke on the human oral mucosal transcriptome. Cancer Prev Res (Phila). 2010;3(3):266–78.

    Article  Google Scholar 

  39. Szabo E. Primer: first do no harm--when is it appropriate to plan a cancer prevention clinical trial? Nat Clin Pract Oncol. 2008;5(6):348–56.

    Article  PubMed  Google Scholar 

  40. Baron JA, Sandler RS, Bresalier RS, Quan H, Riddell R, Lanas A, Bolognese JA, Oxenius B, Horgan K, Loftus S, et al. A randomized trial of rofecoxib for the chemoprevention of colorectal adenomas. Gastroenterology. 2006;131(6):1674–82.

    Article  PubMed  Google Scholar 

  41. Bresalier RS, Sandler RS, Quan H, Bolognese JA, Oxenius B, Horgan K, Lines C, Riddell R, Morton D, Lanas A, et al. Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial. N Engl J Med. 2005;352:1092–102.

    Article  PubMed  Google Scholar 

  42. Lubet RA, Scheiman JM, Bode A, White J, Minasian L, Juliana MM, Boring DL, Steele VE, Grubbs CJ. Prevention of chemically induced urinary bladder cancers by naproxen: protocols to reduce gastric toxicity in humans do not alter preventive efficacy. Cancer Prev Res (Phila). 2015;8(4):296–302.

    Article  Google Scholar 

  43. Wu X, Lippman SM. An intermittent approach for cancer chemoprevention. Nat Rev Cancer. 2011;11(12):879–85.

    Article  PubMed  Google Scholar 

  44. Rahman MA, Amin AR, Shin DM. Chemopreventive potential of natural compounds in head and neck cancer. Nutr Cancer. 2010;62(7):973–87.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Lan A, Li W, Liu Y, Xiong Z, Zhou S, Palko O, Chen H, Kapita M, Prigge JR, Schmidt EE, et al. Chemprevention of oxidative stress-associated oral carcinogenesis by sulforaphane depends on NRF2 and the isothiocyanate moiety. Oncotarget. 2016;7:53502–14.

    PubMed  PubMed Central  Google Scholar 

  46. Chikara S, Nagaprashantha LD, Singhal J, Horne D, Awasthi S, Singhal SS. Oxidative stress and dietary phytochemicals: role in cancer chemoprevention and treatment. Cancer Lett. 2018;413:122–34.

    Article  PubMed  Google Scholar 

  47. Bauman JE, Zang Y, Sen M, Li C, Wang L, Egner PA, Fahey JW, Normolle DP, Grandis JR, Kensler TW, et al. Prevention of carcinogen-induced oral cancer by sulforaphane. Cancer Prev Res (Phila). 2016;9(7):547–57.

    Article  Google Scholar 

  48. Pollak M. Metformin and other biguanides in oncology: advancing the research agenda. Cancer Prev Res (Phila). 2010;3(9):1060–5.

    Article  Google Scholar 

  49. Heckman-Stoddard BM, Gandini S, Puntoni M, Dunn BK, DeCensi A, Szabo E. Repurposing old drugs to chemoprevention: the case of metformin. Semin Oncol. 2016;43(1):123–33.

    Article  PubMed  Google Scholar 

  50. Vitale-Cross L, Molinolo AA, Martin D, Younis RH, Maruyama T, Patel V, Chen W, Schneider A, Gutkind JS. Metformin prevents the development of oral squamous cell carcinomas from carcinogen-induced premalignant lesions. Cancer Prev Res (Phila). 2012;5(4):562–73.

    Article  Google Scholar 

  51. Yen YC, Lin C, Lin SW, Lin YS, Weng SF. Effect of metformin on the incidence of head and neck cancer in diabetics. Head Neck. 2015;37(9):1268–73.

    Article  PubMed  Google Scholar 

  52. Mak MP, William WN Jr. Targeting the epidermal growth factor receptor for head and neck cancer chemoprevention. Oral Oncol. 2014;50(10):918–23.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Leeman-Neill RJ, Seethala RR, Singh SV, Freilino ML, Bednash JS, Thomas SM, Panahandeh MC, Gooding WE, Joyce SC, Lingen MW, et al. Inhibition of EGFR-STAT3 signaling with erlotinib prevents carcinogenesis in a chemically-induced mouse model of oral squamous cell carcinoma. Cancer Prev Res (Phila). 2011;4(2):230–7.

    Article  Google Scholar 

  54. Zhou G, Hasina R, Wroblewski K, Mankame TP, Doci CL, Lingen MW. Dual inhibition of vascular endothelial growth factor receptor and epidermal growth factor receptor is an effective chemopreventive strategy in the mouse 4-NQO model of oral carcinogenesis. Cancer Prev Res (Phila). 2010;3(11):1493–502.

    Article  Google Scholar 

  55. Cohen EEW, Soulieres D, LeTourneau C, Dinis J, Licitra L, Ahn M-J, Soria A, Machiels J-P, Mach N, Mehra R, et al. Pembrolizumab versus methotrexate, docetaxel, or cetuximab for recurrent or metastatic head-and-neck squamous cell carcinoma (KEYNOTE-040): a randomised, open-label, phase 3 study. Lancet. 2018;393(10167):156–67.

    Article  PubMed  Google Scholar 

  56. Spira A, Yurgelun MB, Alexandrov L, Rao A, Bejar R, Polyak K, Giannakis M, Shilatifard A, Finn OJ, Dhodapkar M, et al. Precancer atlas to drive precision prevention trials. Cancer Res. 2017;77(7):1510–41.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Volik S, Alcaide M, Morin RD, Collins C. Cell-free DNA (cfDNA): clinical significance and utility in cancer shaped by emerging technologies. Mol Cancer Res. 2016;14(10):898–908.

    Article  PubMed  Google Scholar 

  58. Mende M, Thiede C, Schuster C, Aust DE, Folprecht G. Detection of tumor progression via cell-free DNA (cfDNA) in patients with colorectal cancer. J Clin Oncol. 2015;33(3_suppl):598.

    Article  Google Scholar 

  59. Izumchenko E, Chang X, Brait M, Fertig E, Kagohara LT, Bedi A, Marchionni L, Agrawal N, Ravi R, Jones S, et al. Targeted sequencing reveals clonal genetic changes in the progression of early lung neoplasms and paired circulating DNA. Nat Commun. 2015;6:8258.

    Article  PubMed  Google Scholar 

  60. Kensler TW, Spira A, Garber JE, Szabo E, Lee JJ, Dong Z, Dannenberg AJ, Hait WN, Blackburn E, Davidson NE, et al. Transforming cancer prevention through precision medicine and immune-oncology. Cancer Prev Res (Phila). 2016;9(1):2–10.

    Article  Google Scholar 

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Loomans-Kropp, H.A., Szabo, E. (2020). Chemoprevention in Oral Cancer. In: Warnakulasuriya, S., Greenspan, J. (eds) Textbook of Oral Cancer. Textbooks in Contemporary Dentistry. Springer, Cham. https://doi.org/10.1007/978-3-030-32316-5_18

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  • DOI: https://doi.org/10.1007/978-3-030-32316-5_18

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