Abstract
Our ability to explore the cancer genome is dependent upon, and limited by, the availability of representative tumour models, the high-quality tissue resource and the capacity of available technologies. Fortunately, there has been great progress in these areas in recent years with next-generation sequencing techniques enabling entire genome sequencing, using a fraction of the resources previously required. Carcinogenesis a multistep and multifactorial process that involves multiple genes with critical events occurring at the DNA level and DNA is a highly stable macromolecule and therefore an excellent resource for biomarker discovery. However, translational perspectives of genomics remain limited which is partly related to intratumour heterogeneity, in which subclones of cells can be present within the same tumour. New advances in therapy will rely upon a greater understanding of the molecular basis of this heterogeneity, and new therapies will have to target the specific characteristics of an individual’s tumour, central to the modern concept of personalised medicine. There is however an emerging molecular classification of HNSCC, with prognostic significance, that is based upon the presence of human papillomavirus and the number of genomic alterations present.
In the last decade, interest has also grown in the epigenetics of cancer. The role of promoter hypermethylation has become a focus for research in many tumour sites, including HNSCC. Silencing of certain TSGs may occur in the absence of genetic change, via aberrant methylation of CpG islands. Several promising avenues exist in attempting to translate this research field into the clinical management of HNSCC. Several suggestions have been made that promoter methylation of specific genes may indicate a particular tumour’s sensitivity to a drug. Epigenetic alterations are particularly interesting since they can potentially be reversed in drug treatment with mechanisms such as epigenetic reprogramming suggested. This opens the door for using epigenetic modifiers as therapeutic agents.
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Dhanda, J., Shaw, R.J. (2016). Genetics and Epigenetics of Head and Neck Cancer. In: Bernier, J. (eds) Head and Neck Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-27601-4_5
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