Capturing and deciphering the molecular signatures of head and neck cancer

Head and neck cancer, while relatively uncommon in the United States remains a prevalent condition throughout the world and potentially has substantial quality of life issues for these patients. As a disease classification, head and neck cancer, represents a diverse population of cancers which are linked anatomically, extending from the clavicles to the skull base. There are many histologic types of cancer within this grouping, although the vast majority are squamous cell carcinomas. The most significant disease sites are the oral cavity, oropharynx, larynx and hypopharynx, while other sites, such as the sinuses, are much less common and more heterogeneous. Treatment for head and neck cancer consists of surgery, radiation therapy and chemotherapy, alone or in combination. The decision to use a particular therapeutic regimen has been related to TNM stage, primary site, and comorbidity of the patient. More recently, molecular studies of head and neck cancer, such as global gene expression, methylation status, microRNA and proteomic changes, continue to identify important alterations in the genetic and molecular make-up of these tumors, all of which will be expanded upon in this chapter.